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A negative Coggins Test Certificate dated since 7/15/10 must be attached for each pony entered.

2011 Maryland Pony Breeders Show


July 15, 16, 17, 2011 ~ Equestrian Center of Harford County
Preentries must be postmarked by June 22, 2011. Stewards will be present to measure ponies all days. Reg. # Color Sex Hgt Age Breeding
Sire

Copies of registration papers and measurement cards for all entries must be attached according to governing breed regulations.

Ofce Use

Registered Name of Pony

Classes

Entry Fee

MC

EIA

Owner

Exhibitor/Rider

Jr. Birth Date

Dam Sire

MC

EIA

Owner

Exhibitor/Rider

Jr. Birth Date

Dam Sire

MC

EIA

Owner

Exhibitor/Rider

Jr. Birth Date

Dam Sire

MC

EIA

Owner

Exhibitor/Rider

Jr. Birth Date

Dam

PLEASE USE ONE ENTRY FORM PER OWNER


Mail entries to: Bonnie Six 2019 Pleasantville Rd, Fallston, MD 21047 For information: 410-692-2800 (day) 410-241-2958 bonnie6@netzero.net Make checks payable to: Maryland Pony Breeders Payment in full must accompany this form. Straw stalls @ $55 each: Shavings stalls @ $65 each: WPCSA fee (performance only) @ $3.00 each: Electric hook-up fee @ $35 each: Truck License #:____________________ Sponsorships: Division, Class, or Patron Ads:

Quantity:

Total:

-- Signatures required on reverse side of form --

Total:

SIGNATURES REQUIRED IN TWO (2) PLACES (AT X) BELOW


ENTRIES NOT SIGNED WILL NOT BE ACCEPTED - CAREFULLY READ THIS AGREEMENT BEFORE SIGNING.
Every entry at this show shall constitute an agreement and affirmation that all participants: (1) shall be subject to the rules of the Maryland Horse Shows Association (MHSA) or the Welsh Pony and Cob Society of America (WPCSA) or the Shetland Pony Society of North America (SPSNA) AND the local rules of the competition; (2) agree that every animal and exhibitor is eligible as entered; (3) agree to be bound by the rules of the MHSA, or WPCSA, or SPSNA and the local competition, and will accept as final the decision of the Officials and the local competition on any question arising under said rules, and agree to hold the competition, the Maryland Pony Breeders, Inc. (MPB), the MHSA, the WPCSA, the SPSNA, their officials, directors and employees harmless for any action taken; and (4) agree that they participate voluntarily in the competition fully aware that equine sports and the competition involve inherent dangerous risks, and by participating they expressly assume all risks of injury or loss, and they agree to indemnify and hold the show committee, the MPB, the MHSA, the WPCSA, the SPSNA, the competition, and their officials, directors, employees, and agents harmless from all claims including injury or loss during or in connection with the competition, whether or not such injury or loss resulted, directly or indirectly, from the negligent acts or omissions of said officials, directors, employees or agents of the MPB, Equestrian Center of Harford County, the MHSA, the WPCSA, the SPSNA, and the competition.

SIGNATURES BELOW INDICATE THAT I HAVE READ AND UNDERSTOOD THE ABOVE:

X________________________________________________
Owner/Agent Signature

X___________________________________________
Rider/Driver/Handler Signature (if a minor Jr., consent must be signed

Print Name:________________________________________ Address:___________________________________________ City/State/Zip:_______________________________________ Email:_____________________________________________ Phone:____________________________________________

Print Name:________________________________________ Address:___________________________________________ City/State/Zip:_______________________________________ Email:_____________________________________________ Phone:____________________________________________

Welsh Pony Owners/Lessees - WPCSA Membership #:________________ Rider/Driver/Handler - WPCSA Membership #:___________________
Junior (Minor) Exhibitor Consent: To be signed by parent, guardian, or if not available,trainer: I hereby consent to the entry of my child in this horse show and acknowledge that I have read this entry form and agree to the applicable terms, condition, waivers, and consents as set forth herein and accept responsibility here under for the participation of said Junior (minor): X__________________________________________________________________________ Parent, guardian, or trainer signature

Maryland Pony Breeders Sponsorship: MPB is asking for your support through sponsorship for our Annual Show and Yearling Futurity.

Ribbon Sponsor ($10.00). Class choice: _________________________________________________________ Patron ($25.00). Listing in show program: ________________________________________________________ Division ($50.00). Division choice: ______________________________________________________________ Other:_____________________________________________________________________________________