Colorado State University Two Phase, Dressage, and Jumper Show Show Date: Saturday November 10, 2012

First Name: ______________________ Last Name: ______________________ Name of Parents/Guardian: ______________________________________________ Owner of horse: _____________________________________ Address: ___________________________________ Town & Zip: _______________________ Phone: ______________________________________Cell:______________________________ E-Mail:_________________________________________________ Name of Horse: Breed: Gender: Color:

Class List:
Dressage ($20/ Class) USDF Introduction A and/or B (Walk/ Trot) USDF Training 1 and/or 3 USDF First 1and/or 3 USDF Second 1 and/or 3 USDF Third 1 and/or 3 USDF Fourth 1 and/or 3 Jumper ($10/ Class) 18 Cross Rails 2 23 26 3 33 36

Combined Classes ($30/ Paired Classes) Elementary- Cross Rails Max 18, USDF Intro B Introductory- Max 23, USDF Begin Nov Test A Beginner Novice- Max 27, USDF Begin Nov B Novice- Max 211, USDF Nov Test A Training- Max 33, USDF Training Test A If there is a class that you wish to enter that is not listed, please contact Chelsea Boggs (show secretary) to ask for special arrangements. Day of show sign up will only be allowed for Jumper classes. Class Description Cost of Class

Total for Classes (Include a $1 fee for back numbers) Stall for a day- $25 Stall for overnight- $45 Day of Show request for stall- $50 (Shavings are not provided for any stalls) EMT Fee- $15
Check Enclosed: # _________________ Total Amount: ___________________________ A certified helmet and proper footwear are required for all participants. If you plan on keeping a horse overnight, you are required to provide a negative coggins and health certificate for that horse.

WARNING Under Colorado law, an equine professional is not liable for any injury to or death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to Section 13-21-119 Colorado Revised Statutes. Chelsea Boggs (Show Secretary) (203)240-0795 cboggs@rams.colostate.edu Please send all entry forms to 1117 City Park Ave. Apt D8, Fort Collins CO 80521