register online

Payment and signatures (open check or cash) for online registrations will be collected at show office on day of show. Sorry, no credit cards are accepted at this time.

Online entries must be received by the Tuesday prior to Date of Show to be considered a Pre- Entry for discount

Only One (1) Horse and One (1) Rider per Entry Form Please

Horse

Horse Name(required)

Horse Age(required)

Horse Height(required)

Horse Color(required)

Horse Sex(required)

Owner/Agent

Owner/Agent First and Last Name(required)

Owner/Agent Address(required)

Owner/Agent City, State and Zip(required)

Owner/Agent Email

Owner/Agent Telephone

Trainer

Trainer First and Last Name

Trainer Address

Trainer City, State and Zip

Trainer Email

Trainer Telephone

Rider

Rider First and Last Name(required)

Rider Address(required)

Rider City, State and Zip(required)

Rider Email

Rider Telephone

Youth Age as of 12/1/2023

Rider Classes (Enter Class Numbers separated by , or ; (i.e. 1, 2, 3 or 4; 23; 87)(required)

Other

USHJA Outreach ID #

# of Day Stall(s) Needed

# of Overnight Stall(s) NeededPlease identify if for Fri/Sat or Sat/Sun

# of Weekend Stall(s) Needed

# of Additional Bags of Shavings Needed (1 bag included per stall)

Please check to acknowledge – signature to be provided when you pick up your number DISCLAIMER: By submitting below as owner, agent, rider, handler, lessee, trainer, coach or as parent or adult guardian of a minor, I am fully aware and acknowledge that equine sports and competitions involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering and/or death (“Harm”). By submitting below, I agree to release the competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted directory or indirectly from the negligence of the competition. If I am submitting as a parent or guardian of a junior exhibitor, I consent to the child’s participation and agree to all of the above provisions and agree to assume all of the obligations of this release on the child’s behalf. I agree that the term “competition” as used above includes, but is not limited to, the horse show, Four Reel Farm, its officials, officers, directors, employees, contractors, agents, personnel, volunteers and affiliated organizations, as well as the facility (Horse Lovers Park and Friends of Horse Lovers Park).(required)

Horse

Owner/Agent

Trainer

Rider

Other

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