OPEN HORSE SHOW ENTRY FORM

SPONSORED BY BEXAR COUNTY 4H HORSE LEADERS

Saturday, November 4, 2017
The Country Church, 1005 FM 78 W. Marion, Texas 78124
Back Number_________ Coggins Date______________

Contestant Name:_____________________________ Age as of 08/01/2017______________

Address: _________________________________________________________ Phone #:_________________
Email: ______________________________________
Horse Name: __________________________ Horse's Gender (Circle One): Mare Gelding Horse's Age:______
Check One I am a Bexar County 4H Member I am NOT a Bexar County 4H Member
4H Club:_________________________________
EACH HORSE NEEDS AN ENTRY FORM AND NUMBER. ONE HORSE PER CLASS FOR HIGH POINT AWARDS.
(You may ride mulitiple horses in a class as an exibition at a cost of $5 per class)
Juniors (13 & Under) Seniors (14 - 18) Adults 19+
English Showmanship English Showmanship English Showmanship
Hunter Under Saddle Hunter Under Saddle Hunter Under Saddle
Hunt Seat Equitation Hunt Seat Equitation Hunt Seat Equitation
Hunter Hack Hunter Hack Hunter Hack
Working Hunter Over Fences Working Hunter Over Fences Working Hunter Over Fences
Equitation Over Fences Equitation Over Fences Equitation Over Fences
Open Jumping Open Jumping Open Jumping
Hunt Seat Versatilty Hunt Seat Versatilty Hunt Seat Versatilty
Western Showmanship Western Showmanship Western Showmanship
Western Pleasure Western Pleasure Western Pleasure
Western Horsemanship Western Horsemanship Western Horsemanship
Western Trail Western Trail Western Trail
Cloverleaf Barrels Cloverleaf Barrels Cloverleaf Barrels
Straightaway Barrels Straightaway Barrels Straightaway Barrels
Poles Poles Poles
Stake Race Stake Race Stake Race

Halter (All Divisions) Walk/Trot (Youth/Adult) Check box Below Show Fees
Halter Mares 4 & Under Youth Adult
Halter Mares 5 & Over Western Showmanship _______$85 All Day Fee (Excludes Exhibitions)
Grand and Reserve Mares English Showmanship _______ Classes x $10
Halter Geldings 4 & Under Hunter Under Saddle _______ Exhibitions x $5
Halter Geldings 5 & Over Hunt Seat Equitation _______ $10 Four Corners
Grand and Reserve Geldings Walk- Trot Cross Rails _______ $15 Office Fee*
Western Pleasure _______$30 Same day Office Fee
Individual Classes Western Horsmanship * Office Fee Waived if received by 10/21/2017
Leadline Total $_________
0.00

Four Corners* ($10 Fee) Make Checks Payable to: Any questions please contact the Show
Bexar County 4H Horse Leaders Secretary @ 210-274-8004
Email Entry Forms to: Kathryn.Hodges@outlook.com or Mail to:
Bexar County 4H 3355 Cherry Ridge Dr. S-212 San Antonio, Texas 78230

**CONTESTANTS MUST READ AND SIGN LIABILITY FORM ON BACK OF THIS PAGE AND MAIL IT IN WITH ENTRY FORM**
*Four Corners is a jackpot class similar to
rollerskating game, but on horseback. Current Coggins Mandatory
Winner take 60% Jackpot. 2017 State 4H Horse Show Rules Followed
 Open Horse Show
Sponsored by Bexar County 4H Horse Leaders

Liability Release Form

I agree that I am participating voluntarily in the above competition and I am fully aware that horse
sports and this competition involve inherent dangerous risks of serious injury or death, and by
participating I expressly assume any and all risks of injury or loss, including death to myself and my
horse and I agree to indemnify and hold Bexar County 4H Horse Leaders and Texas A&M AgriLife
Extension Service (4H), their agents, employees, volunteers, and all other persons connected with
4H, individually or collectively, harmless from and against all claims including for any injury or loss
suffered during or in acts or omissions of said Bexar County 4H Horse Leaders and Texas A&M
AgriLife Extension Service, their agents, employees, volunteers, and all other persons connected with
4H, individually or collectively.
By the act of entering this show, owners, lessees, and exhibitors agree that Texas A&M AgriLife
Extension Service, the sponsoring charter/club, the show grounds and the show committee will not be
held responsible for any loss, injury, damage or debts in connection with this show.
WARNING: UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE) AN
EQUINE PROFESSIONAL IS NOT LIABLE FOR ANY INJURY TO OR THE DEATH OF A
PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE
ACTIVITIES.

Riders Signature:
____________________________

Parent/Guardian Signature if rider is under 18:

____________________________

Print Parent/Guardians Name:

____________________________

Emergency Contact_______________________Relationship_____________Phone#____________

Texas A&M AgriLife Extension provides equal opportunities in its programs and employment to all persons regardless of race, color, sex, religion,
national origin, disability, age, genetic information, veterans status, sexual orientation, or gender identity.