Ozark Heartland Arabian Fall Classic One Day Qualifer Show I
September 27, 2014
Ozark Heartland Arabian Fall Classic One Day Qualifer Show II September 28, 2014 Managed & Produced by: Equine Ventures Unlimited, LLC Pre-Entries Close Sept 22, 2014 (Pre-entry required for premuim stalls) Flying M Arena Mt. Vernon, Missouri Competitions I & II are AHA qualifying shows for Region XI Judge for Show I: Annette Turnbaugh Grand View, MO.
Judge for Show II: Dawn K. Coons Cat Springs, TX. NO Late Fees!!!!!!! CAN Enter on day of Show! Hotels Te Ofcial Show Hotel: Americas Best Inn & Suites (Ask for show discount) 1125 E. Daniel Drive, Mt. Vernon, MO 65712 Phone: 417-466-4511 Fax: 417-466-4247 Other Hotels: Te Mt. Vernon Inn Mt. Vernon, MO 65712 417-466-0230 Te American Lodge & Suites of Republic 950 Austin Lane, Republic, MO 65738 417-732-5335 8802 Highway M, Mt. Vernon, Mo. 65712 (417) 849-5219
Arabian Horse Association Show Recognition Competition Sponsor: AHA Recognition Show/Recording Number: Join AHA through your local club for the following great member benets: Discounted subscription to Modern Arabian Horse magazine Reduced rate for competition privileges across a variety of disciplines for local, regional and national AHA-approved shows and rides Peace of mind with 1 million in personal liability insurance through Equisure Preferred rates on horse registrations and transfers Preferred rates on ArabDataSource, the worlds largest online Arabian horse resource Numerous opportunities to participate in award recognition and prize money programs Show circuits for AHA members at local, regional and national levels Contact your local club: The Arabian Horse Association is a major equine association serving members in the United States and Canada. It registers and maintains a database of more than one million Arabian, Half-Arabian and Anglo- Arabian horses and administers more than $2.5 million in annual prize money. AHA produces championship events, recognizes over 500 Arabian horse shows and distance rides annually and provides activities and programs that promote breeding and ownership. For information about Arabian, Half-Arabian and Anglo-Arabian horses, call 303-696-4500, e-mail info@ArabianHorses.org or visit ArabianHorses.org. Arabian Horse Association 10805 East Bethany Drive Aurora, CO 80014 303.696.4500 303.696.4599 fax ArabianHorses.org AHA 090032 (Rev. 2/13) The Judges & Stewards Commissioner is responsible for handling written and signed complaints relating to judges and stewards conduct when fled by exhibitors, show offcials, AHA members or others, and when accompanied by a ten-dollar ($10.00) fling fee [Resolution 5-90]. Other comments, compliments, questions, inquiries are encourageed when appropriate (no fling fee required). Write: Judges & Stewards Commis- sioner, 10805 E. Bethany Dr., Aurora, CO 80014; (303) 696-4539. Southwest Missouri Arabian Horse Club 141112395 - 141112396 Premiums In-Hand and Performance Classes will be judged to six places. Equitation Classes................................................................................................. 6 Ribbons Walk-Trot Classes................................................................................................. 6 Ribbons Breeding and Gelding In-Hand Classes Show I................................................ 6 Ribbons Breeding and Gelding In-Hand Classes Show II.............................................. 6 Ribbons Breeding and Gelding In-Hand Championships in Show I & II....................2 Ribbons Performance Classes in Show I........................................................................... 6 Ribbons Performance Class Championships in Show I.................................................. 6 Ribbons Performance Classes in Show II.......................................................................... 6 Ribbons Performance Class Championships in Show II................................................. 6 Ribbons High Point Trophy to the High Point Horse of the Weekend!! High Point Awards to be give to High Point Horse of each show.
Show Fees Equitation Class Entry Fee......................................................................................... $10.00 Breeding and Gelding In-Hand Entry Fee Show I & II .........................................$15.00 Breeding and Gelding In-Hand Championship Entry Fee Show I & II ................ $0.00 Performance Class Entry Fee Show I & II ................................................................$15.00 Performance Class Championship Entry Fee Show I & II ....................................$20.00 Ofce Fee per Horse ....................................................................................................$20.00 Number Fee per Horse or per Equitation Rider ........................................................$1.00 AHA Single-Event Fee per Person per Show............................................................$35.00 Permanent Horse Stall with a Door ..........................................................................$60.00 Permanent Tack Stall with a Door ............................................................................$60.00 Tie Out Fee per Horse (Showing out of your trailer) per Day ..............................$15.00 Fee for Trailer/RV Hookup per Night.......................................................................$20.00 TBA (To Be Added) Class Fee Show (Pay with Entry Form) ...........................$30.00 Fee for "NO SHOWING" any Class............................................................................$5.00 Ozark Heartland Arabian Fall Classic One Day Qualifer Show I September 27, 2014 Ozark Heartland Arabian Fall Classic One Day Qualifer Show II September 28, 2014 Managed & Produced by: Equine Ventures Unlimited, LLC Show Conduct Te Southwest Missouri Arabian Horse Club, its Directors and Ofcers and Show Management reserve the right to refuse any entry of any horse owner, trainer, groom, agent or exhibitor before these shows without ANY compensation, damages or liability. Past objectionable attitude toward this show or any previous unsportsmanlike behavior at this show is grounds for refusal of the entry. Show Management may also order horses, their owners and/or exhibitors of the show premises without being held liable for damages of any kind. If you sign the entry form, you agree to the above. COURTESY: Any act of discourtesy to a judge or ofcial at this show by an owner, trainer, exhibitor, groom or agent shall be grounds to disqualify the horse associated with the ofending individual. Discourtesy to ex- hibitors (or their help) by exhibitors, horse owners, trainers, grooms or agents carries the same disqualif- cation. Show management and/or the show steward will act upon complaints. If you sign the entry form, you agree to this paragraph. In the event of discourteous behavior, all fees and winnings shall be forfeited. ADDING CLASS ENTRY: If an exhibitor wishes to enter classes not originally listed on the entry form, that exhibitor must complete an Entry/Add form in the show ofce one hour before that session starts. CANCELING CLASS ENTRY: Exhibitors are required to complete an Entry/Cancel form if a horse is entered and will not be competing. Failure to do so will incur a NO SHOW fee of $5.00 per class. CALLS FOR CLASSES: Te public address system must be considered a courtesy and no war- ranty can be made that everyone will be able to hear class calls from all places on the grounds. It is the responsibility of the exhibitor to be at the gate for the class without regard to announcements. COMBINING, DIVIDING AND CANCELING CLASSES: Show management reserves the right to divide classes with 15 or more entries, and to combine classes with too few entries. Only classes with no entries will be canceled. GATE HOLD/TACK CHANGE: A two minute gate hold may be granted by the ofcial gate keeper for tack change. Please notify the gate keeper of a tack change requirement as much in advance of the class as possible. In classes without a "gate hold", the gate will be open for two minutes from the time the frst horse in that class enters the ring. NOTE: Whips longer than six feet are not allowed at ringside or in the warm-up arenas. Fire extinguishers, air horns and explosives used as training aids are prohibited on the show grounds before, during and afer the show. Fire extinguishers so used will be confscated and the ofenders will be reported to USEF. No attention-getting de- vices outside of standard approved appointments are allowed in the warm-up areas, ringside or in the show ring. IDENTIFICATION NUMBERS: Every horse/equitation rider will be assigned an identifcation number which must be worn by the rider, driver or handler while in the show ring. A one-time, non-refundable fee of $1 per number will be charged. SHOW TABS: An open, signed check may be lef in the show ofce. Added classes will be run on this tab. SHOW OFFICE: Te show ofce will open on Friday, September 26, 2014, 5 pm. A schedule of the ofce hours will be posted outside and inside the show ofce. Barn/stall postitions will be posted outside of the show ofce or outside the arena entrance. ABS CLASSES: Arabian Breeders Sweepstakes classes may be entered by horses that are or are not nominated. ABS prize money may be earned by those horses enrolled in the "Points Payback Program". Enrolling in the "Points Payback Program" must be done prior to the show. Contact AHA at 303-696-4500. ABS Classes are designated by "$" before the class name. RULE ENFORCEMENT: Te show committee and show management will enforce all rules of USEF, AHA and the Horse Protection Act from the time horses enter the show grounds until their departure. Show man- agement and its designated individuals reserve the right to measure the length of any horse's feet at any time or place and to have any horse's shoe or shoes pulled and weighed without being liable for compensation or damages. Show management also reserves the right to inspect or examine the personal efects and proper- ty of every exhibitor, owner, trainer, his employees or agents for the possession of illegal drugs, ginger or elec- trical devices used in schooling or showing horses. If you sign the entry form, you agree to this paragraph. CONFLICTS: Any errors or omissions in this premium book and/or any conficts will be resolved at the show ofce by show management. ALL DECISIONS OF SHOW MANAGEMENT ARE FINAL. If you sign the entry form, you agree to this paragraph. Cruelty or the abuse of a horse by any person is strictly forbidden. Stabling and Show Facilities STALLS: Permanent stalls with doors (10'X10') are available. Tack stalls may be limited if necessary. Te Show Committee reserves the right to ask exhibitors to forfeit a tack stall if additional "horse" stalls are required. Grooming stalls must remain uncovered at all times. Shavings must be purchased from the "Flying M Arena". Minimum one bag of shavings per stall. No outside bedding allowed. One horse per stall only. If forbidden bedding is used, a $25.00 fee will be assessed. All stalls must be purchased from the Equine Ventures Unlimited, LLC. Stalls are limited and will be assigned on a frst-come frst-served basis. Absolutely no stalls will be held without payment. ARENA: Te show will be held in an indoor arena (246' x 125', sand based footing). Exhibitors will be permitted to work horses in the show arena before, between and afer sessions; however, arena preparation needs will determine exact cut-of times. Te show arena will be open for working horses on Friday, September 26, 2014 afer 12:00 noon. WARM-UP ARENAS: Te warm-up arena (120' x 80', sand based footing) is also indoor. ARRIVAL TIME: Horses will be accepted on Friday, September 26, 2014 , afer 12 noon. Call Barb McDannald 417-849-5219 if earlier arrival time is needed. A $20 fee will be charged for each additional day. DEPARTURE TIME: All horses must depart the show grounds no later than noon, Sept. 29th . Later departure may be granted by show management. A $20 fee will be charged for the additional night in the stall. If you leave items in a tack stall for an additional night, you will also be charged for that stall. GROUND TIE: Exhibitors who wish to show out of their trailer may do so. Te fee for each day will be $15 per horse. TRAILER/RV HOOKUPS: Water and Electric are included in the $20.00 per night fee. Pay with entry form. SHARPS: Containers are available at least one per ffy horse-occupied stalls for the disposal of needles and other sharp instruments. Containers will be replaced when full. Show management may fme individuals, includ- ing trainers, owners, exhibitors or their agents up to $100 for improper disposal of sharps. USEF Art. GR1210.4. HAY, GRAIN AND BEDDING: Bermuda hay , Lakin Milling alfalfa pellets and shavings will be available on the grounds for purchase. Feed store hours will be posted in the show ofce. WASH RACKS: Covered wash racks are located between the two main barns. DOGS: All dogs are to be leashed/restrained at all times. No dogs will be allowed inside the show or warm-up arenas with the exception of those dogs trained to aid the disabled. No dogs should be in the gate areas. RESTAURANT FACILITIES: Restaurant facilities are available on the fairgrounds, openning one hour before the show, and closing at the end of the show day. SMOKING IS NOT PERMITTED INSIDE THE ARENA OR IN THE BARNS. SPECTATORS: All spectator behavior should be such that it does not interfere with horses or riders in the arena. Please be aware that inexperienced and/or young riders and horses are participating in our shows. Children run- ning up and down the bleacher steps make distractingly loud footfalls. No hands or feet may rest on or above the show arena railing. Please be considerate while watching the riders/horses who have worked so hard just to be in competition. INDEMNITY/NON-RESPONSIBILITY CLAUSE: Neither the Southwest Missouri Arabian Horse Club, the Fly- ing M Arena, Equine Ventures Unlimited LLC, nor the City of Mt. Vernon, Missouri, shall be responsible for loss of any type, personal injury or damage to horses exhibited; or for any article of any kind or nature that may be lost, destroyed or damaged. Directors, ofcers and employees of the above are also held harmless for any loss. Te signed entry form signifes knowledge and acceptance of these conditions. WARNING: Under Missouri Law an equine professional is not liable for an injury to or the death of a partici- pant in equine activities resulting from the inherent risks of equine activities pursuant to the revised statutes of Missouri. Defnitions: AATR: Adult Amateur to Ride JTR: Junior to Ride JTH: Junior to Handle AHA: Arabian Horse Association HA/AA: Half-Arabian/Anglo-Arabian Limit Rider USEF Art. GR134* ATH: Amateur to Handle ATR: Amateur to Ride QC: Qualifying Class PB: Purebred Arabian USEF: U.S. Equestrian Federation, Inc ABS: Arabian Breeders Sweepstakes classes- Nominated and non-nominated horses may enter. Classes are designated by "$" before the class name in this premium book. * Limit horses/riders may not have won six frst place ribbons in that particular performance section. AHA MEMBERSHIP STATEMENT EACH COMPETITOR (THIS INCLUDES AT LEAST ONE RECORDED OWNER AND ALL TRAINERS, DRIVERS, RID- ERS, HALTER HANDLERS, COACHES AND THE PERSON(S) SIGNING THE ENTRY BLANK) IN AN ARABIAN HORSE AS- SOCIATION RECOGNIZED ARABIAN DIVISION, AT THE TIME OF ENTRY INTO A COMPETITION, MUST SUBMIT A COPY OF A VALID AHA MEMBERSHIP/COMPETITION CARD, JOIN AHA OR PAY AN AHA SINGLE EVENT MEMBERSHIP FEE PER COMPETITOR. WHEN AN AGENT SIGNS FOR THE OWNER AT AN AHA RECOGNIZED COMPETITION, BOTH THE OWNER AND AGENT MUST BE MEMBERS OF AHA OR PAY THE AHA SINGLE EVENT MEMBERSHIP. SINGLE EVENT MEMBERSHIP IS NOT ACCEPTABLE AT AHA REGIONAL OR NATIONAL COMPETITIONS. EXHIBITORS IN WALK-TROT CLASSES ARE EXEMPT FROM AHA MEMBERSHIP REQUIREMENTS AT QUALIFY- ING COMPETITIONS, BUT MUST HAVE AN AHA MEMBERSHIP WITH COMPETITION CARD AT AHA REGIONAL AND NATIONAL COMPETITIONS. EXHIBITORS IN LEAD LINE CLASSES OR PARENTS/GUARDIANS SIGNING FOR MINORS ARE EXEMPT FROM AHA MEMBERSHIP REQUIREMENTS. (BOD 5/12) Te Southwest Missouri Arabian Horse Club Ozarks Heartland Arabian Fall Classic Shows I & II Show Ofcials Judge for Show I ...................................................... Ms. Annette Turnbaugh, Grandview, MO Judge for Show II ............................................................. Ms. Dawn K Coons, Cat Springs, TX Show Secretary .......................................................... Mr. Lenard Davenport, Springfeld, MO 417-861-9192 ....................................................................................lendavenport@prodigy.net Safety Cooridnator....................................................................................Mr. Troy Murrell, MO Barn Manager .......................................................................Mr. Troy Murrell, Bois D'Arc, MO 417-425-9322 ............................................................................................. slider74@yahoo.com Veterinarian ...............................................................Dake Veterinarian Services, Miller , MO. 417-452-3301 Announcer ................................................................................................... Ms. Rennee Knight Ringmaster for Show I & II.................................................................................Robert Schanke Farrier ...................................................................................................................................TBA To reach the show ofce during the show times, please use Lenard Davenport's cell: 417-861-9192. To reach the facility please use Barbara McDannald's cell: 417-849-5219.
To reach the barn manager, please useTroy Murrell's cell: 417-425-9322. Managed & Produced by: Equine Ventures Unlimited, LLC Approved by: Shows I & II: Te Arabian Horse Association --- Region XI Qualifying Pre-Entry Deadline: September 22, 2014
Ozark Heartland Arabian Fall Classic Show I Saturday, September 27th, 2014 One Day Qualifer Tentative Class Schedule Saturday September 27th, FIRST SESSION 8 a.m. Class# AHA# Fee$ Class Name 101 210 15 PB Western Trail, Open 102 645 15 HA/AA Western Trail, Open 103 179 15 PB English Trail, Open 103 a 691 15 HA/AA English Trail, Open 104 211 20 PB Western Trail Championship, Open, (QC 101) 105 646 20 HA/AA Western Trail Championship, Open (QC 102) Short Break to tear down Trail obstacles 106 961 15 PB Most Classic Head, 2 and over, Open 107 961 15 PB Most Classic Head, Yearling & Weanling, Open 108 422 15 $HA/AA Mare Breeding 2 & Over, Open 109 418 15 HA/AA Mares, ATH 110 401 HA/AA Mare Breeding Championship, Open (QC 108, 109) 111 472 15 $HA/AA Geldings In- Hand 2 & Over, Open 112 468 15 HA/AA Geldings, ATH 113 451 HA/AA Gelding In-Hand Championship, Open (QC 111, 112) 114 450 15 HA/AA Colt/Gelding, Yearling & Weanling, Open 115 026 15 PB Geldings, Open 116 034 15 PB Geldings, ATH 117 027 PB Gelding Championship, Open (QC 115, 116) 118 008 15 $PB Mares, 2 & Over, Open 119 15 PB Fillies, Yearling & Weanlings, Open 120 009 15 PB Mares, ATH 121 2 PB Mares, Championship, Open (QC 119, 120) 122 019 15 $PB Stallions, 2 & Over, Open 123 14 15 PB Colts, Yearling & Weanlings, Open 124 021 15 PB Stallions, ATH 125 15 PB Stallions, Championship, Open (QC 122, 124) 126 918 15 PB/HA/AA Showmanship,18 & Under 127 15 Get of Sire (minimum of 2 foals/per sire, maximum of 4 foals/sire; sire does not have to be present) 128 15 Produce of Dam (minimum of 2 foals/dam, maximum of 4 foals/dam; dam does not have to be present Break TBA Saturday September 27, SECOND SESSION 129 290 15 $PB Hunter Pleasure, Open 130 733 15 $HA/AA Hunter Pleasure, Open 131 1631 15 PB Hunter Pleasure, AATR 132 1630 15 HA/AA Hunter Pleasure, AATR 133 299 15 PB Hunter Pleasure, ATR 134 741 15 HA/AA Hunter Pleasure, ATR 135 299 15 PB Hunter Pleasure, JTR 136 741 15 HA/AA Hunter Pleasure, JTR 137 290 15 PB Hunter Pleasure, Limit Horse 138 733 15 HA/AA Hunter Pleasure, Limit Horse 139 291 20 PB Hunter Pleasure Championship, Open, (QC 129, 137) 140 734 20 HA/AA Hunter Pleasure Championship, Open, (QC 130, 138) 141 300 20 PB Hunter Pleasure Championship, ATR, (QC 129, 131, 133, 137) 142 742 20 HA/AA Hunter Pleasure Championship, ATR, (QC 130, 132, 134, 138) 143 939 15 PB/HA/AA Hunt Seat Not to Jump Equitation, 18 & under 144 30 TBA Break TBA Saturday September 27, THIRD SESSION 145 15 PB Liberty, Open 146 10 UPHA Walk/Trot Challenge Cup, Rider 10 & Under 147 10 UPHA Challenge Cup, Riders 18 & under 148 10 NSH Equitation 18 and under 149 956 10 UPHA Arabian Breeds Challenge Cup, Riders 18 & under 150 30 TBA 151 890 15 PB/HA/AA Walt-Trot Pleasure, English, Country English, & Hunter, 10 & under 152 075 15 $PB English Pleasure, Open 153 515 15 $HA/AA English Pleasure, Open 154 083 15 PB English Pleasure, ATR 155 524 15 HA/AA English Pleasure, ATR 156 076 20 PB English Pleasure Championship, Open, (QC 152, 154) 157 516 20 HA/AA English Pleasure Championship, Open, (QC 153, 155) 158 30 TBA 159 095 15 $PB Country English Pleasure, Open 160 540 15 $HA/AA Country English Plea sure, Open 161 1633 15 PB Country English Pleasure, AATR 162 1640 15 HA/A Country English Pleasure, AATR 163 104 15 PB Country English Pleasure, ATR 164 549 15 HA/AA Country English Pleasure, ATR 165 104 15 PB Country English Pleasure, JTR 166 549 15 HA/AA Country English Pleasure, JTR 167 096 20 PB Country English Pleasure Championship, Open, (QC 159, 161, 163, 165) 168 105 20 PB Country English Pleasure Championship,ATR, (QC 161, 163, 165) 169 541 20 HA/AA Country English Pleasure Championship, Open, (QC 160, 162, 164, 166) 170 550 20 HA/AA Country English Pleasure Championship, ATR, (QC 162, 164, 166) 171 925 15 PB/HA/AA Saddle Seat Equitation, 18 & under 172 907 15 PB/HA/AA Walk-Trot Equitation, English, Country English & Hunter, 10 & under 173 30 TBA Break TBA 174 890 15 PB/HA/AA Walt-Trot Western Pleasure, 10 & under 175 190 15 $PB Western Plea sure, Open 176 620 15 $HA/AA Western Pleasure, Open 177 206 15 PB Western Pleasure, AATR 178 619 15 HA/AA Western Pleasure, AATR 179 198 15 PB Western Pleasure, ATR 180 629 15 HA/AA Western Pleasure, ATR 181 198 15 PB Western Pleasure, JTR 182 629 15 HA/AA Western Pleasure, JTR 183 190 15 PB Western Pleasure, Limit Horse 184 620 15 HA/AA Western Pleasure, Limit Horse 185 191 20 PB Western Pleasure Championship, Open, (QC 175, 177, 179, 181, 183) 186 199 20 PB Western Pleasure Championship, ATR, (QC 177, 179,181) 187 621 20 HA/AA Western Pleasure Championship, Open, (QC 176,178, 180, 182, 184) 188 630 20 HA/AA Western Pleasure Championship,ATR, (QC 178,180,182) 189 949 15 PB/HA/AA Western Seat Equitation, 18 & under 190 907 15 PB/HA/AA Walk-Trot Western Seat Equitation, 10 & under 191 15 Adult Walk-Trot Western Pleasure 192 150 15 PB Native Costume 193 590 15 HA/AA Native Costume 194 30 TBA 195 225 15 $PB Reining, Open 196 660 15 $HA/AA Reining, Open Total Entry Fees ------------------------------------- $ ______
_____ AHA Resolution 9-90 @ $4.00 --------------- $ _______ _____ Box Stalls $60.00 for weekend ------------- $ _______
_____ Tack Stall $60.00 for weekend -------------- $ _______ Show Pass/Single Event Fees: _____ AHA Single Event Fee @35.00 -------------- $ _______ Other Fees _____ Back Number Fee @$1.00 ------------------- $ _______ _____ Misc ------------------------------------------------ $ _______ _____ Misc ------------------------------------------------ $ _______ _____ Misc ----------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______
TOTAL FEES DUE ------------------------------- $-------------
Ozark Heartland Arabian Fall Classic I One Day Qualifier September 27, 2014 Pre-Entries Close Sept 22, 2014 PLEASE TYPE OR PRINT ONLY ONE HORSE PER ENTRY FORM. Horses Name Reg. No. DOB MM/DD/YY Sex Color Sweepstakes Yes No
Sire Dam Rider 1 Classes / TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA# Address City State Zip Rider 2 Classes TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA# Address City State Zip Rider 3 Classes TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA#
Address City State Zip
Each person signing this entry form acknowledges that he/she has read the front and reverse of this Entry Form and agrees to the applicable terms, conditions, waivers ALL OWNERS, TRAINERS, RIDERS, DRIVERS & HANDLERS MUST SIGN ON THE BACK. Minor entrants must also have parent/guardian signat ure(s) on the back., releases, indemnification and consent as set forth herein. Each person agrees that the information is accurate to the best of his/her knowledge.
THE FOLLOWING MUST BE SENT WITH YOUR ENTRIES Photo copies of AHA, Membership cards for each Rider/Driver/Handler/ Trainer/Owner, Horses Registation papers & Purchase contract if applicable and Stall Reservation Forms
OWNER INFORMATION Owner name as it appears on registration papers/purchase contract Name ______________________________________________________________________________________________ AHA#____________________________ Current Address __________________________________________________________ Phone _______________________ City___________________________________________________________ ST ___________ Zip ____________________ Email _______________________________________________________________________________________________ TRAINER INFORMATION (must be filled out, if there is no trainer, owner may write same in trainer information) Name ______________________________________________________________________________________________ AHA# ____________________________ Address ________________________________________________________________ Phone _______________________ City_____________________________________________________________ ST __________ Zip ____________________ Email _______________________________________________________________________________________________ Stable with __________________________________________________________________________________________
ENTRIES CLOSE Date Make Checks payable to : Equine Ventures Unlimited, LLC Mail to: Equine Ventures Unlimited Lenard Davenport 231 South James River Landing Nixa, MO. 65714
ALL ENTRY FORMS MUST BE PROPERLY SIGNED ON BACK OFFICE USE ONLY Office Use Total $ Paid $ Check Number Date Rcvd
AHA ENTRY AGREEMENT I have read the rules concerning competitions as printed in the Arabian Horse Association (AHA) Handbook / Directory and Competition Prize List and agree to be bound by and subject to those Rules. AHA ASSUMPTION OF RISK, RELEASE AND INDEMNIFICATION Tis document waives very important legal rights. Read it carefully before signing. In consideration for AHA permitting me to participate in this Competition, and by signing the entry blank, I agree as follows: I AGREE that I choose to participate voluntarily in this Competition, as a rider, driver, handler, lessee, owner, agent, coach, trainer, junior exhibitor, or as a parent or guard- ian of a junior exhibitor. I AM FULLY AWARE AND ACKNOWLEDGE THAT HORSE SPORTS AND PARTICIPATION IN THIS COMPETITION INVOLVE SERIOUS RISK OF HARM INCLUDING, BUT NOT LIMITED TO, RISKS OF ACCIDENT, SERIOUS BODILY INJURY, INCLUDING DEATH, BROKEN BONES, HEAD INJU- RIES, TRAUMA, PAIN, AND SUFFERING, AND PROPERTY DAMAGE. I ASSUME ALL RISKS OF HARM TO ME, MY HORSE OR MY PROPERTY. I AGREE for myself, my heirs, executors, administrators, successors and assigns to release AHA, the Competition, the facilities leased by the Competition and the owner(s) of the facilities, and all of their respective ofcers, ofcials, directors, employees, agents, personnel, volunteers, afliated organizations and insurers (collectively, the "Re- leased Parties") from any and all claims for damage, loss, or injury to myself, other persons, horses or other property belonging to me to the fullest extent permitted by law that arises out of or relates in any way to the Competition and my participation in the Competition INCLUDING, BUT NOT LIMITED TO, DAMAGES, LOSS, OR INJURY RESULTING FROM ANY ACTS, FAILURE TO ACT, NEGLIGENCE OR NEGLECT OF OTHER ENTRANTS, THE RELEASED PARTIES, THEIR CONTRAC- TORS OR INVITEES, as well as for thef, vandalism, fre, other casualty damage, or damage arising out of any defects in the premises. I AGREE to indemnify and hold harmless (that is pay all losses, damages, attorneys fees and costs of) the Released Parties from and against any and all claims, demands, penalties, actions, losses, costs, damages, injuries, liabilities and obligations (including attorneys fees) of whatsoever kind and nature, which may be asserted against or incurred by any of them as a result of (1) my participation in the Competition or (2) any act, failure to act, or neglect (a) by me, my agents, employees, riders, handlers, trainers, coaches, drivers, contractors or invitees, or (b) by any animal owned or exhibited by me or in my custody or control. I AGREE and represent that I am qualifed and eligible to enter and/or participate in the Competition, and every horse I am entering is qualifed and eligible as entered. I AGREE to accept AS FINAL any decision of AHA, the Show Commission or Show Ofcials concerning my qualifcation or the qualifcation of my horse to enter the Competition or any results of the Competition, except to the extent that the Rules of AHA, the Competition, CEF or USA Equestrian permit a protest or hearing of such decisions. Should a hearing be requested, I agree to accept AS FINAL the decision of the particular hearing body. I agree to release, hold harmless and not to sue AHA, the Competition Sponsor, their ofcers, directors, employees, volunteers or members concerning any decision of AHA, the Competition, its Show Commission, Show Ofcials or any hearing body that relates to my qualifcations or my horse(s) qualifcations to enter the Competition or any results of the Competition. I AGREE that AHA has the sole right to control, sell, supervise or give away (or assign to others the right to do so) the exclusive rights to broadcast, televise, reproduce, transmit and disseminate all or part of this event, and I agree that AHA may use or assign, in any way AHA sees ft, photographs, flms, videos, audios, cablecasts, or other likenesses of me and my horse taken during the course of the Competition for the promotion, coverage or beneft of the Competition or AHA. Tose likenesses shall not be used to advertise a product and they may not be used in such a way which implies endorsement of any company, product, product category or service. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropria- tion. By signing below as a parent or guardian of a junior exhibitor, I consent to the childs participation and agree to all of the above provisions, and further agree to assume all of the obligations of this AHA Assumption of Risk, Release and Indemnifcation personally and on behalf of the child. Tis AHA Assumption of Risk, Release and Indemnifcation is governed by the Laws of the State of Colorado and is intended to be interpreted as broadly as possible. I agree that exclusive jurisdiction and venue (place) for any legal action against AHA, its ofcers, directors, employees, volunteers or agents shall be in the local district courts or the federal court of the State of Colorado. If any part of this agreement is determined to be unenforceable, all other parts shall remain efect. BY SIGNING BELOW, I AGREE to be bound by all applicable Associations Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and efect as if I afxed my signature by my own hand. BOD 1/23/11 Efective 12/1/11 Owner ** Mandatory**Print Name _______________________________________________Signature___________________________________________________ ______________________________________________________________________________________________________________________________________ Trainer or Custodian of horse @ show ** Mandatory Print Name _________________________Signature ________________________________________________ ______________________________________________________________________________________________________________________________________ Rider 1 ** Mandatory Print Name _________________________________________________Signature ________________________________________________ Rider 2 ** Mandatory if there is a 2nd rider Print Name _______________________________Signature ________________________________________________ Rider 3 ** Mandatory if there is a 3rd rider Print Name _______________________________Signature ________________________________________________
Print Minor Name Here _____________________________________Print Parent/Guardian Signature ____________________________________________________________ Print Minor Name Here _____________________________________Print Parent/Guardian Signature ____________________________________________________________ ****** EMERGENCY PHONE NUMBER FOR EXHIBITOR _____________________________________________________________ MUST BE SIGNED IN AT LEAST 3 PLACES BY ADULTS ONLY AHA Membership is not required for Parents/Guardians signing for minors. Ozark Heartland Arabian Fall Classic Show II Sunday, September 28th, 2014 One Day Qualifer Tentative Class Schedule Sunday September 28th, FIRST SESSION 8 a.m. Class# AHA# Fee$ Class Name 201 210 15 PB Western Trail, Open 202 645 15 HA/AA Western Trail, Open 203 179 15 PB English Trail, Open 203 a 691 15 HA/AA English Trail, Open 204 211 20 PB Western Trail Championship, Open, (QC 201) 205 646 20 HA/AA Western Trail Championship, Open (QC 202) Short Break to tear down Trail obstacles 206 961 15 PB Most Classic Head, 2 and over, Open 207 961 15 PB Most Classic Head, Yearling & Weanling, Open 208 422 15 $HA/AA Mare Breeding 2 & Over, Open 209 418 15 HA/AA Mares, ATH 210 401 HA/AA Mare Breeding Championship, Open (QC 208, 209) 211 472 15 $HA/AA Geldings In- Hand 2 & Over, Open 212 468 15 HA/AA Geldings, ATH 213 451 HA/AA Gelding In-Hand Championship, Open (QC 211, 212) 214 450 15 HA/AA Colt/Gelding, Yearling & Weanling, Open 215 026 15 PB Geldings, Open 216 034 15 PB Geldings, ATH 217 027 PB Gelding Championship, Open (QC 215, 216) 218 008 15 $PB Mares, 2 & Over, Open 219 1 15 PB Fillies, Yearling & Weanlings, Open 220 009 15 PB Mares, ATH 221 2 PB Mares, Championship, Open (QC 219, 220) 222 019 15 $PB Stallions, 2 & Over, Open 223 14 15 PB Colts, Yearling & Weanlings, Open 224 21 15 PB Stallions, ATH 225 015 PB Stallions, Championship, Open (QC 222, 224) 226 918 15 PB/HA/AA Showmanship,18 & Under 227 15 Get of Sire (minimum of 2 foals/per sire, maximum of 4 foals/sire; sire does not have to be present) 228 15 Produce of Dam (minimum of 2 foals/da m, maximum of 4 foals/da m; dam does not have to be present) Break TBA Sunday September 28th, SECOND SESSION 229 290 15 $PB Hunter Pleasure, Open 230 733 15 $HA/AA Hunter Pleasure, Open 231 1631 15 PB Hunter Pleasure, AATR 232 1630 15 HA/AA Hunter Pleasure, AATR 233 299 15 PB Hunter Pleasure, ATR 234 741 15 HA/AA Hunter Pleasure, ATR 235 299 15 PB Hunter Pleasure, JTR 236 741 15 HA/AA Hunter Pleasure, JTR 237 290 15 PB Hunter Pleasure, Limit Horse 238 733 15 HA/AA Hunter Pleasure, Limit Horse 239 291 20 PB Hunter Pleasure Championship, Open, (QC 229, 237) 240 734 20 HA/AA Hunter Pleasure Championship, Open, (QC 230, 238) 241 300 20 PB Hunter Pleasure Championship, ATR, (QC 229, 231, 233, 237) 242 742 20 HA/AA Hunter Pleasure Championship, ATR, (QC 230, 232, 234, 238) 243 939 15 PB/HA/AA Hunt Seat Not to Jump Equitation, 18 & under 244 30 TBA Break TBA Sunday September 28th, THIRD SESSION 245 15 PB Liberty, Open 246 10 UPHA Walk/Trot Challenge Cup, Rider 10 & Under 247 10 UPHA Challenge Cup, Riders 18 & under 248 10 NSH Equitation 18 and under 249 956 10 UPHA Arabian Breeds Challenge Cup, Riders 18 & under 250 30 TBA 251 890 15 PB/HA/AA Walt-Trot Pleasure, English, Country English, & Hunter, 10 & under 252 075 15 $PB English Pleasure, Open 253 515 15 $HA/AA English Pleasure, Open 254 083 15 PB English Pleasure, ATR 255 524 15 HA/AA English Pleasure, ATR 256 076 20 PB English Pleasure Championship, Open, (QC 252, 254) 257 516 20 HA/AA English Pleasure Championship, Open, (QC 253, 255) 258 30 TBA 259 095 15 $PB Country English Pleasure, Open 260 540 15 $HA/AA Country English Plea sure, Open 261 1633 15 PB Country English Pleasure, AATR 262 1640 15 HA/A Country English Pleasure, AATR 263 104 15 PB Country English Pleasure, ATR 264 549 15 HA/AA Country English Pleasure, ATR 265 104 15 PB Country English Pleasure, JTR 266 549 15 HA/AA Country English Pleasure, JTR 267 096 20 PB Country English Pleasure Championship, Open, (QC 259, 261, 263, 265) 268 105 20 PB Country English Pleasure Championship,ATR, (QC 261, 263, 265) 269 541 20 HA/AA Country English Pleasure Championship, Open, (QC 260, 262, 264, 266) 270 550 20 HA/AA Country English Pleasure Championship, ATR, (QC 262, 264, 266) 271 925 15 PB/HA/AA Saddle Seat Equitation, 18 & under 272 907 15 PB/HA/AA Walk-Trot Equitation, English, Country English & Hunter, 10 & under 273 30 TBA Break TBA 274 890 15 PB/HA/AA Walt-Trot Western Pleasure, 10 & under 275 190 15 $PB Western Pleasure, Open 276 620 15 $HA/AA Western Pleasure, Open 277 206 15 PB Western Pleasure, AATR 278 619 15 HA/AA Western Pleasure, AATR 279 198 15 PB Western Pleasure, ATR 280 629 15 HA/AA Western Pleasure, ATR 281 198 15 PB Western Pleasure, JTR 282 629 15 HA/AA Western Pleasure, JTR 283 190 15 PB Western Pleasure, Limit Horse 284 620 15 HA/AA Western Pleasure, Limit Horse 285 191 20 PB Western Pleasure Championship, Open, (QC 275, 277, 279, 281, 283) 286 199 20 PB Western Pleasure Championship, ATR, (QC 277, 279, 281) 287 621 20 HA/AA Western Pleasure Championship, Open, (QC 276, 278, 280, 282, 284) 288 630 20 HA/AA Western Pleasure Championship,ATR, (QC 278, 280, 282) 289 949 15 PB/HA/AA Western Seat Equitation, 18 & under 290 907 15 PB/HA/AA Walk-Trot Western Seat Equitation, 10 & under 291 15 Adult Walk-Trot Western Pleasure 292 150 15 PB Native Costume 293 590 15 HA/AA Native Costume 294 30 TBA 295 225 15 $PB Reining, Open 296 660 15 $HA/AA Reining, Open Sunday September 28. Academy Classes(Open to any lesson horse, all breeds and disiplines welcome) 301 10 Academy Walk/Trot Pleasure 302 10 Academy Walk/Trot Equitation 303 10 Academy Walk/Trot/Canter Plesure 304 10 Academy Walk/Trot/Canter Equitation 305 20 Academy Walk/Trot Championship 306 20 Academy Walk/Trot/Canter Championship TBA Classes PB Park,Open PB English Pleasure, AATR or JTR PB English Pleasure,Championship,ATR PB English Pleasure,Junior Horse PB Country English Pleasure,Junior Horse PB Pleasure Driving,Open PB Country Pleasure Driving, Open PB Ladies Side Saddle,Open PB English Trail,Championship,Open PB English Trail,ATR or AATR or JTR PB Western Pleasure,Junior Horse PB Western Trail,Junior Horse PB Western Trail,ATR or AATR or JTR PB Reining,Championship,Open PB Reining, ATR or AATR or JTR PB Reining,Junior Horse PB Hunter Pleasure,Junior Horse PB English Show Hack,Open PB English Show Hack, ATR or AATR or JTR HA/AA Park, Open HA/AA English Pleasure, AATR or JTR HA/AA English Pleasure,Championship,ATR HA/AA English Pleasure,Junior Horse HA/AA Country English Pleasure,Junior Horse HA/AA Pleasure Driving,Open HA/AA Country Pleasure Driving,Open HA/AA Ladies Side Saddle,Open HA/AA English Trail,Open HA/AA English Trail,ATR or AATR or JTR HA/AA Western Pleasure Championship, ATR HA/AA Western Pleasure,Junior Horse HA/AA Western Trail, ATR or AATR or JTR HA/AA Reining,Open or ATR or AATR or JTR HA/AA Reining,Junior Horse HA/AA Show Hack,Open HA/AA English Trail,Championship,Open PB/HA/AA Showmanship,ATR or AATR PB/HA/AA Reining Seat Equitation,JTR PB/HA/AA Hunter Seat Equitation Not to Jump,JTR PB/HA/AA Western Horsemanship,JTR PB/HA/AA Walk-Trot Pleasure,English,Country English,Hunter,Championship (10 & under) PB/HA/AA Walk-Trot Pleasure,Western Championship (10 & under) PB/HA/AA Walk-Trot Equitation,English,Country English,Hunter,Championship (10 & under) PB/HA/AA Walk-Trot Equitation,Western Championship (10 & under) Total Entry Fees ------------------------------------- $ ______
_____ AHA Resolution 9-90 @ $4.00 --------------- $ _______ _____ Box Stalls $50.00 for weekend ------------- $ _______
_____ Tack Stall $50.00 for weekend -------------- $ _______ Show Pass/Single Event Fees: _____ AHA Single Event Fee @35.00 -------------- $ _______ Other Fees _____ Back Number Fee @$1.00 ------------------- $ _______ _____ Misc ------------------------------------------------ $ _______ _____ Misc ------------------------------------------------ $ _______ _____ Misc ----------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______ _____ Misc ------------------------------------------------- $ _______
TOTAL FEES DUE ------------------------------- $-------------
Ozark Heartland Arabian Fall Classic II One Day Qualifier September 28, 2014 Pre-Entries Close Sept 22, 2014 PLEASE TYPE OR PRINT ONLY ONE HORSE PER ENTRY FORM. Horses Name Reg. No. DOB MM/DD/YY Sex Color Sweepstakes Yes No
Sire Dam Rider 1 Classes / TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA# Address City State Zip Rider 2 Classes TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA# Address City State Zip Rider 3 Classes TOTAL FEES Entry Fees $ Name DOB MM/DD/YY Amateur Certificate Yes No Junior/AmateurRelationship to horse owner AHA#
Address City State Zip
Each person signing this entry form acknowledges that he/she has read the front and reverse of this Entry Form and agrees to the applicable terms, conditions, waivers ALL OWNERS, TRAINERS, RIDERS, DRIVERS & HANDLERS MUST SIGN ON THE BACK. Minor entrants must also have parent/guardian signat ure(s) on the back., releases, indemnification and consent as set forth herein. Each person agrees that the information is accurate to the best of his/her knowledge.
THE FOLLOWING MUST BE SENT WITH YOUR ENTRIES Photo copies of AHA, Membership cards for each Rider/Driver/Handler/ Trainer/Owner, Horses Registation papers & Purchase contract if applicable and Stall Reservation Forms
OWNER INFORMATION Owner name as it appears on registration papers/purchase contract Name ______________________________________________________________________________________________ AHA#____________________________ Current Address __________________________________________________________ Phone _______________________ City___________________________________________________________ ST ___________ Zip ____________________ Email _______________________________________________________________________________________________ TRAINER INFORMATION (must be filled out, if there is no trainer, owner may write same in trainer information) Name ______________________________________________________________________________________________ AHA# ____________________________ Address ________________________________________________________________ Phone _______________________ City_____________________________________________________________ ST __________ Zip ____________________ Email _______________________________________________________________________________________________ Stable with __________________________________________________________________________________________
ENTRIES CLOSE Date Make Checks payable to: Equine Ventures Unlimited, LLC Mail to: Equine Ventures Unlimited Lenard Davenport 231 South James River Landing Nixa, MO. 65714
ALL ENTRY FORMS MUST BE PROPERLY SIGNED ON BACK OFFICE USE ONLY Office Use Total $ Paid $ Check Number Date Rcvd
AHA ENTRY AGREEMENT I have read the rules concerning competitions as printed in the Arabian Horse Association (AHA) Handbook / Directory and Competition Prize List and agree to be bound by and subject to those Rules. AHA ASSUMPTION OF RISK, RELEASE AND INDEMNIFICATION Tis document waives very important legal rights. Read it carefully before signing. In consideration for AHA permitting me to participate in this Competition, and by signing the entry blank, I agree as follows: I AGREE that I choose to participate voluntarily in this Competition, as a rider, driver, handler, lessee, owner, agent, coach, trainer, junior exhibitor, or as a parent or guard- ian of a junior exhibitor. I AM FULLY AWARE AND ACKNOWLEDGE THAT HORSE SPORTS AND PARTICIPATION IN THIS COMPETITION INVOLVE SERIOUS RISK OF HARM INCLUDING, BUT NOT LIMITED TO, RISKS OF ACCIDENT, SERIOUS BODILY INJURY, INCLUDING DEATH, BROKEN BONES, HEAD INJU- RIES, TRAUMA, PAIN, AND SUFFERING, AND PROPERTY DAMAGE. I ASSUME ALL RISKS OF HARM TO ME, MY HORSE OR MY PROPERTY. I AGREE for myself, my heirs, executors, administrators, successors and assigns to release AHA, the Competition, the facilities leased by the Competition and the owner(s) of the facilities, and all of their respective ofcers, ofcials, directors, employees, agents, personnel, volunteers, afliated organizations and insurers (collectively, the "Re- leased Parties") from any and all claims for damage, loss, or injury to myself, other persons, horses or other property belonging to me to the fullest extent permitted by law that arises out of or relates in any way to the Competition and my participation in the Competition INCLUDING, BUT NOT LIMITED TO, DAMAGES, LOSS, OR INJURY RESULTING FROM ANY ACTS, FAILURE TO ACT, NEGLIGENCE OR NEGLECT OF OTHER ENTRANTS, THE RELEASED PARTIES, THEIR CONTRAC- TORS OR INVITEES, as well as for thef, vandalism, fre, other casualty damage, or damage arising out of any defects in the premises. I AGREE to indemnify and hold harmless (that is pay all losses, damages, attorneys fees and costs of) the Released Parties from and against any and all claims, demands, penalties, actions, losses, costs, damages, injuries, liabilities and obligations (including attorneys fees) of whatsoever kind and nature, which may be asserted against or incurred by any of them as a result of (1) my participation in the Competition or (2) any act, failure to act, or neglect (a) by me, my agents, employees, riders, handlers, trainers, coaches, drivers, contractors or invitees, or (b) by any animal owned or exhibited by me or in my custody or control. I AGREE and represent that I am qualifed and eligible to enter and/or participate in the Competition, and every horse I am entering is qualifed and eligible as entered. I AGREE to accept AS FINAL any decision of AHA, the Show Commission or Show Ofcials concerning my qualifcation or the qualifcation of my horse to enter the Competition or any results of the Competition, except to the extent that the Rules of AHA, the Competition, CEF or USA Equestrian permit a protest or hearing of such decisions. Should a hearing be requested, I agree to accept AS FINAL the decision of the particular hearing body. I agree to release, hold harmless and not to sue AHA, the Competition Sponsor, their ofcers, directors, employees, volunteers or members concerning any decision of AHA, the Competition, its Show Commission, Show Ofcials or any hearing body that relates to my qualifcations or my horse(s) qualifcations to enter the Competition or any results of the Competition. I AGREE that AHA has the sole right to control, sell, supervise or give away (or assign to others the right to do so) the exclusive rights to broadcast, televise, reproduce, transmit and disseminate all or part of this event, and I agree that AHA may use or assign, in any way AHA sees ft, photographs, flms, videos, audios, cablecasts, or other likenesses of me and my horse taken during the course of the Competition for the promotion, coverage or beneft of the Competition or AHA. Tose likenesses shall not be used to advertise a product and they may not be used in such a way which implies endorsement of any company, product, product category or service. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropria- tion. By signing below as a parent or guardian of a junior exhibitor, I consent to the childs participation and agree to all of the above provisions, and further agree to assume all of the obligations of this AHA Assumption of Risk, Release and Indemnifcation personally and on behalf of the child. Tis AHA Assumption of Risk, Release and Indemnifcation is governed by the Laws of the State of Colorado and is intended to be interpreted as broadly as possible. I agree that exclusive jurisdiction and venue (place) for any legal action against AHA, its ofcers, directors, employees, volunteers or agents shall be in the local district courts or the federal court of the State of Colorado. If any part of this agreement is determined to be unenforceable, all other parts shall remain efect. BY SIGNING BELOW, I AGREE to be bound by all applicable Associations Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and efect as if I afxed my signature by my own hand. BOD 1/23/11 Efective 12/1/11 Owner ** Mandatory**Print Name _______________________________________________Signature___________________________________________________ ______________________________________________________________________________________________________________________________________ Trainer or Custodian of horse @ show ** Mandatory Print Name _________________________Signature ________________________________________________ ______________________________________________________________________________________________________________________________________ Rider 1 ** Mandatory Print Name _________________________________________________Signature ________________________________________________ Rider 2 ** Mandatory if there is a 2nd rider Print Name _______________________________Signature ________________________________________________ Rider 3 ** Mandatory if there is a 3rd rider Print Name _______________________________Signature ________________________________________________
Print Minor Name Here _____________________________________Print Parent/Guardian Signature ____________________________________________________________ Print Minor Name Here _____________________________________Print Parent/Guardian Signature ____________________________________________________________ ****** EMERGENCY PHONE NUMBER FOR EXHIBITOR _____________________________________________________________ MUST BE SIGNED IN AT LEAST 3 PLACES BY ADULTS ONLY AHA Membership is not required for Parents/Guardians signing for minors.