EQUINE VENTURES UNLIMITED I

Entry Form
May 16-17, 2015
One animal per form.

Mail Entries to:

Equine Ventures Unlimited

Lenard Davenport
231 S. James River Landing
Nixa, MO. 65714-8900

Registered Name of Horse

ABCD

ABCD

ABCD

ABCD

ABCD

ABCD

ABCD

Office Use Only

Account_________________
Group/Trainer____________________
EIA____________________________

Registration Number

ABCD

ABCD

ABCD

Sex

ABCD

ABCD

ABCD

Year Foaled

ABCD

ABCD

Class Number Entered (one class per box). Circle A, B, C or D below each Box to indicate the Handler/Driver for that class.
Please DO NOT USE STABLE OR FARM NAME for Handler must use current member name
_____Open/Amateur Classes: @$35.00 $____________

Youth
_____Youth Classes
@$25.00 $____________
Handler/Driver Name A__________________________Age____Amateur/Junior #_______________
_____
Flat
Fee
Classes
@$100.00 $____________

Signature of parent/Guardian if Junior Exhibitor__________________________________
One animal for pre-entered classes only

Youth
Handler/Driver Name B__________________________Age_____ Amateur/Junior #______________
____Late Entry Fee
@$25.00$_____________

Signature of parent/Guardian if Junior Exhibitor__________________________________
For Entries made day of show plus regular class fees.

Youth
_____Stall
Fee (10X10)
@$45.00 $____________
Handler/Driver Name C__________________________Age_____ Amateur/Junior #______________
Fri. Noon to Mon.. Noon. Two animal max per stall.

Signature of parent/Guardian if Junior Exhibitor__________________________________

Youth
_____ Bags of Shavings
@$8.00 $______________
Handler/Driver Name D__________________________Age____ Amateur/Junior #_______________
Must order from Flying M and pay in advance.

Signature of parent/Guardian if Junior Exhibitor__________________________________
____Tie out fee@$8.00
$____________
Per Animal / Per day. NO overnight tie-out allowed.
Owner Name_______________________________Email_______________________
_____Office Fee: Per Pony
@$8.00 $____________
Address_______________________________City___________State______Zip____
____RV/Trailer Hook-up
@$20.00 $____________
Telephone___________________
Per day for water & electric.
Total Enclosed
$ ___________
Make Checks Payable To: Equine Ventures Unlimited
Visa/Mastercard/Discover ONLY

Credit Card # ___________- __________-_________-________Exp. date____-____Security Code (_____)

Office Use Only

Check #___________Amount $_______________

Name_______________________________Date:__________________

Additional Payments $_____________________

STATEMENT OF RESPONSIBILITY
AND LIABILITY
The show is approved by ASPC/AMHR and its management team will not be responsible for accidents that may occur to, or be caused by, any equine
exhibited at the show or for any article of any kind or nature that may be lost or destroyed. Each exhibitor will be responsible for any injury that
may be occasioned to any person or animal, or damage to any property while on the show grounds by any horse owned, exhibited or in his custody or control and shall indemnify and hold harmless the A.S.P.C./AMHR, Equine Ventures Unlimited LLC and Flying M Enterprises. LLC and
its management team, its directors individually and collectively, from and against all claims, demands, cause of action, costs, charges, and expense
of every kind and nature arising out of or which may be incurred by reason of any accident, injury, or damages to person or property caused by
the ownership, exhibition, custody or control of animals exhibited. Presentation of signed entry blanks shall be deemed acceptance of these rules
and in the event of failure to sign the entry blank, the first entry into the show ring as an exhibitor shall be deemed to be the acceptance of rules.
(THREE SIGNATURE REQUIRED)
OWNER _________________________________________________________________________ Date_________
TRAINER ________________________________________________________________________Date_________
RIDER/DRIVER/HANDLER _________________________________________________________Date_________
Parent or Guardian must sign for Youth
Rider/Driver/Handler (NAME) _______________________________________________________Date________
Parent or Guardian (SIGNATURE) ___________________________________________________Date_________
Rider/Driver/Handler- NAME _______________________________________________________Date________
Parent or Guardian- SIGNATURE ____________________________________________________Date________