Exhibitor: ________________________________ Age: ___________

Address: _________________________________ Birth Date: ______

City. State, Zip: ____________________________ Phone: __________

Name of Horse: ____________________________ Horse’s Age: _____

Color: _______________ Breed: _______________ MARE GELDING STALLION

CLASSES (Please circle classes you wish to enter)

1 2 3 4 5 6 7 8 9 10 11 12

13 14 15 16 17 18 19 20 21 22 23 24

25 26 27 28 29 30 31 32 33 34 35 36

37 38 39 40 41 42 43 44 45 46 47 48

49 50 51

COSTS & FEES:

YLCR Member Classes ____ X$10.00 = $ _____

Non Member Classes ____ X$12.00 = $ _____

Showmanship Processing Fee $7.00 = $ _____

Grounds Fee (per horse) $5.00 = $ _____

TOTAL = $ _____

CASH CHECK #: OPEN CHECK #:

DISCLAIMER:

Every entry at this competition shall constitute an agreement and affirmation that all participants (which include, without limitation, the owner, lessee, trainer, manager, agent, coach, rider, handler and the horse), for themselves, their principals, representatives, employees and agents (1) shall be subject to the rules of AHSA, Yorba Linda Country Riders (YLCR) and the local rules of competition; (2) represent that every horse, rider and handler is eligible as entered; (3) agree to be bound by the rules of the YLCR and the competition, and will accept as final the decision of the YLCR Board of Directors on any question arising under said rules, and agree to hold the competition, YLCR, their officials, directors and employees harmless for any action taken; (4) agree that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk of serious injury or death, and by participating they expressly assume any and all loss, and they agree to hold YLCR, their officials, directors, employees and agents harmless from and against all claims including for any injury or loss suffered during or in connection with the competition, whether or not such claim, injury, or loss resulted, directly or indirectly from negligent acts or omissions of said officials, directors, employees or agents of the YLCR or competition. I agree to indemnify and save harmless the Yorba Linda Country Riders, owners of the Buena Vista Equestrian Center, the City of Yorba Linda and singular, the directors, officers, members, employees and agents thereof form and against any and all loss, costs or expenses or any claim thereof, of whatever nature arising or to arise on account or by reason of the entry or entries hereby made.

I hereby represent and agree that in the event that the entries hereby made are made for and on behalf of any exhibitor under the age of 18 years, that I am one of the parents of such minor, or duly appointed legal guardian of such minor, and as such, entitled to make this entry for and on behalf of such minor, and I further hereby represent and agree that in the event that the entry hereby made for and on behalf of another person other than a minor under the age of 18 years, I have full authority and privilege from such other person to make such entry or and on behalf of such person

SIGNATURE OF EXHIBITOR, OR PARENT/GUARDIAN, if a minor

X_______________________________________________________________________________ DATE ___________

** YLCR posts pictures on their website that are taken at their events. If you do not want your pictures used please sign here and turn into the YLCR Show Booth **

X_______________________________________________________DATE________