Western Entry Form Show 2 of 3 August 28, 2022
Section 1 (Rider & Horse Information)
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Membership - You must be a member to qualify for end-of-year awards. Find application at https://Isliphorsemensassociation.com/membership *
Required
Name of Trainer (Type "none" if no trainer) *
Name of Horse *
Name of Rider *
Street Address *
Town *
State *
Zip Code *
Rider Date of Birth *
MM
/
DD
/
YYYY
Email Address *
Contact Phone Number *
Reining Classes
Halter & In Hand Classes
Youth Division
Buckaroo Division
All Age Division
Walk/Jog Division
Beginner Division.  NOTE:  If you enter classes in this division, you cannot cross-enter into Beginner Ranch classes/division.  You may only enter All Age classes/division.
Open Division.  NOTE:  If you enter classes in this division, you cannot cross-enter Open Ranch classes/division.  You may only enter All Age classes/division.
Intro Ranch Division
Beginner Ranch Division.  NOTE:  If you enter classes in this division, you cannot cross-enter into Beginner Pleasure classes/division.  You may only enter All Age classes/division.
Open Ranch Division  NOTE:  If you enter classes in this division, you cannot cross-enter into Open Pleasure classes/division.  You may only enter All Age classes/division.
Entry Total:  Pre-Entry Fee (if entered on or before 9:00 PM Thursday, July 21):  $15.00 each class for IHA members; $20.00 for each class non-members; All Post-Entry Fee:  $25.00 each class (no post-entries taken after 9:00 pm Friday, July 22).  Add the following mandatory fees to entry fees:  $5.00 SCP fee; $5.00 Secretary Fee; $10.00 Judge's fee.  IHA MEMBERS ONLY:  One (1) free class for every six (6) horse/rider combination classes entered.  DOES NOT apply to post-entries. **Type entry fee total amount below. If submitting via PayPal:  amcauley25@gmail.com** *
RELEASE OF LIABILITY:  Please read and type your name as acceptance:  By accepting my entry and signing this form (either digitally or written), I understand and hereby release and hold harmless Islip Horsemen's Association, Inc., the County of Suffolk and the Horse Show Committee or any of their agents for any injury or loss suffered during or in connection with the show.  If exhibitor is under the age of 18 as of DECEMBER 1 of 2021, this release must be signed by a parent or designated adult representative. *
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