PISCATAQUA HOUNDS HUNTER TRIALS

ENTRY FORM

Name of Rider:_______________________________________   Jr:____ Sr:____

   Address: ________________________________________________________

   Telephone #: _____________________  E-Mail:_________________________

Name of Horse: _____________________________________________________

Division: (check where applicable. Horses may enter only one division plus pairs.

Anyone may ride in Pairs, whether they have competed previously or not.)

Divisions may be divided into Junior Senior if entries warrant.

____ Hilltopper………………… $40 ($30 if under 18)

____ Ratcatcher .………………$40

____ Field Hunters …………… $ 40

____ Hunter Pairs …….…...……$25

RELEASE:

All competitors must read and sign below:

I understand that riding is a high risk sport and am participating at my own risk.  I hereby assume this risk and further do release and hold harmless the organizer, judges and officials, Piscataqua Hounds and all volunteers, the host of this event, and the owners of any property on which the event or show is to be held, for all liability for negligence resulting in accidents, damage, injury or illness to myself and to my property, including the horse or horses on which I will compete in this event.

Signature: __________________________________________________

(parent or guardian if under 18)

Please include a copy of a current Coggins. Your entry is not complete without it.

Please send Entries to: Houston Farm

C/O Anna Airey

422 Bauneg Beg Hill RD

N. Berwick Me 03906