##formID6e32a4fdcd53699379950004722626f1end##

Do not enter anything in this text box otherwise your message will not be sent! ENTRIES ARE DUE THE TUESDAY BEFORE THE SHOW. USE THE TAB KEY TO MOVE BETWEEN FIELDS, NOT THE ENTER KEY EQUINE NAME EQUINE BREED EQUINE AGE EXHIBITOR NAME EXHIBITOR AGE as of January 1st EXHIBITOR DIVISION(s) MAILING ADDRESS (required) CITY, STATE, ZIP EMAIL PHONE NUMBER PACKAGE RATE: 8 classes (regular or championship), 1 stall, and office/EMT fees for $110. At the show $130. ENTER CLASS NUMBERS IN BOXES BELOW. REGULAR CLASSES $11 EACH PEE WEE/LEADLINE CLASSES $8 EACH CHAMPIONSHIP CLASSES $13 EACH HORSE/TACK STALLS $25 EACH STALL WITH SHAVINGS $7 EACH CAMPER FEE YEAR END REGISTRATION FEE $10 PER DIVISION OFFICE/EMT FEE $10 (REQUIRED) Exhibitors can get a $25 credit off show fees for every $100 in sponsorships they get :) DID YOU GET SPONSORSHIPS? IF SO, HOW MUCH? TOTAL SHOW FEES $ If paying via PayPal, send payments to shellyedson@aol.com If paying via Venmo, send payments to @Shelly-Edson (blue butterflies) If paying via debit/credit card, please enter info below. DEBIT/CREDIT CARD # EXPIRATION DATE CCV BILLING ZIP CODE ADDITIONAL COMMENTS In consideration of the Champlain Valley Horse Shows allowing my participation in this event, I, on behalf of myself, and my heirs, administrators, personal representatives, assigns and children and spouse, if any, do hereby agree to hold harmless, release and discharge Champlain Valley Horse Shows (CVHS) and Addison County Fair and Field Days (ACFD), which includes its officers, directors, members, agents, representatives, affiliates and insurers, of and from all claims, demands, causes of action and legal liability whether known or unknown, anticipated or unanticipated, due to the ordinary negligence of CVHS or ACFD. I shall not bring any claims, demands, legal actions or causes of action against CVHS or ACFD for any damage or loss due to bodily injury, death or property damage arising out of my participation in this event. Photos taken at CVHS Shows may be used for promotional purposes. If paying via Credit/Debit card, your signature below authorizes CVHS to charge the card listed on the entry form for all relevant show fees. UNDER VERMONT LAW, AN EQUINE ACTIVITY SPONSOR IS NOT LIABLE FOR AN INJURY TO, OR THE DEATH OF, A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES THAT ARE OBVIOUS AND NECESSARY, PURSUANT TO 12 V.S.A. § 1039. SIGNATURE OF EXHIBITOR (Parent/Guardian needs to sign if under 18) BY CLICKING SUBMIT, I AGREE TO ABIDE BY ALL THE RULES OF THE CVHS HORSE SHOW SERIES.