rein_for_roses_2016_pl

Ollie Galligan
photo ©John O’Hara
WCRHA Affiliate #2, Region Qualifying Show
FEATURING THE MAY 7th
Brookside Show Park, Elk Grove, CA
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SAN FRANCISCO, TAHOE AND BEAUTIFUL NAPA VALLEY
ONLY 2 HOURS AWAY FROM OUR FACILITY!
Rancho Cordova
(916) 691-1900
(916) 478-9000
(916) 851-1550
(916) 631-7500
(916) 635-4040
SILVA’S
SHELDON
INN
(916) 686-8330
(916) 686-8543
(916) 686-6622
(916) 681-6767
Call Brookside Show Park @ 916-682-1403
to setup your Showcation
Reserve an RV to stay local and enjoy the evenings
Reserve a golf cart for easy travel around the
grounds
Hookups for your own Living Quarters Trailer
DERBY DAY
Parade of Hats
List of Officials
NHRA JUDGES
Leslie Temple, Texas
Donnie Bricker, California
DERBY AND MATURITY EQUIPMENT JUDGE
Beverly Le Master, Sacramento
STAFF
Bill Madden • Facility Owner
Lorraine Kemper • Show Manager
Thad Carr • NRHA Show Representative
Anna-Lise Kozlowski • Show Secretary
Jaimin Kozlowski • Show Office Assistant
Anne Elliott • Show Scribe
Jeanne Akins • Announcer
Joann Campas • Schooling Pen Manager/Announcer
SHOW PHOTOGRAPHER
John O’Hara Photography
SHOW VIDEOGRAPHER
Classic Video - Lavoy Shepard
BROOKSIDE CONTACT INFORMATION (During Show) Brookside Facility Show Office (916) 682-1403
For Advance Reservations for Entries, RV, Stall, Shavings – Call Secretary at (209) 712-3836
THIS SHOW IS WCRHA AFFILIATE #2 AND IS A QUALIFYING SHOW FOR WESTERN REGIONAL AFFILIATE FINALS
SHOW & CLASS INFORMATION
GROUNDS
STABLING - Stalls do not include bedding. We encourage you to order
bedding IN ADVANCE. Call Brookside Equestrian Park at (916) 6821403. There are no outside orders for shavings accepted on the grounds.
HAUL IN – Horses on grounds without a stall will be charged a $20
grounds fee per day. Haul ins may not park in the barn area, only in the
designated areas.
ANIMAL CONTROL – Dogs must be kept on leashes at all times.
ENTRIES
Mail your completed entry form with payment or open check payable to:
Brookside
Mail to: Anna-Lise Kozlowski - R4R, 25328 N. Cherokee Lane - Galt, CA
Entries must include:
a copy of your NRHA Membership Card
a copy of the OWNER’s NRHA Membership Card(s)
a copy of your WCRHA Membership Cards *membership required for
Regional Qualifying and Year End Awards recognition
a copy of your NRHA Competition License
APHA Classes offered for Open, Youth and Amateur (Non Pro)
Requires copies of APHA registration and membership.
draws will be posted on www.brooksideshowpark.com and west coast
designated site if available and time allows to do so. We appreciate your
understanding.
ENTRIES
ALL NRHA CLASS DESIGNATIONS WILL BE MANAGED PER THE
2015 NRHA RULEBOOK.
FOR NRHA and APHA approved CLASSES, IT IS THE RESPONSIBILITY
OF THE OWNER, EXHIBITOR TO CONFIRM:
• Class eligibility to ensure you are eligible to show in that class and or
category.
• Ownership restrictions associated with non pro, youth and rookie to ensure
eligibility.
FOR WEST COAST REINING HORSE ASSOCIATION CLUB LEVEL
CLASSES Descriptions are posted on the website.
http://www.wcrha.com
FOR NRHA ANCILLARY AND ENTRY LEVEL CLASSES, DETAILS ARE
POSTED ON THE NRHA WEBSITE
http://www.nrha.com
MEMBERSHIPS/LICENSES Associate Membership, WCRHA and NRHA
membership/Comp License will be available for purchase or renewal during
the show
IF YOU NEED ASSISTANCE WITH CLASS INFORMATION, PLEASE
CALL THE SHOW SECRETARY – LORRAINE KEMPER
(916)584-5407 or email: fourfootart@yahoo.com
SHOW FEES –All horses entered in the show will be charged for State of
California Drug Fee. $5.00 Per Horse
NO EMAIL and NO text entries accepted.
POST-ENTRIES – All entries received after April 26,2016 will incur a
$25 post entry fee per horse. Entries at the show will be charged a late
entry fee of $25 per horse. * Derby. Maturity horses may enter at the show
without penalty
If an exhibitor enters a class that is designated concurrent, the exhibitor is
only showing once to the judge and will only pay one judges fee.
CONCURRENT CLASSES
Please check class schedule for class closing times and show start times.
If an exhibitor enters multiple categories for a concurrent set of classes, the
rider is only showing once to the judge and will receive the same score in all
class categories entered.
RETURNED CHECKS – Checks returned by the bank for any reason will
be charged $25 PLUS other fees incurred by the bank.
It is the exhibitors responsibility to confirm entry in all appropriate
categories on a concurrent class PRIOR to showing.
REFUNDS – If you pre-entered and need to cancel, Cancellations made
before the start of the1st day of the show will receive a refund of all
payments except the office fee.
Judges Fees: When you enter concurrent classes (such as Limited Open +
Intermediate Open, Non Pro + Prime Time Non Pro) you only have to pay
the judge’s fee once.
VIDEOGRAPHER / PHOTOGRAPHER FEES – Due to the current cost of
having a photographer and videographer at the show, the photo/video feel
will be $8.00 per run. This will be calculated at the end of the show in the
show office. (Example : If your horse shows 4 separate times at the show,
your fee will be 4 x $8.00 = $32). *Concurrent classes are 1 run.
To enter and show in prime time class category, the rider/exhibitor must
meet eligibility requirements per NRHA rules. The exhibitor does NOT
need to cross enter other categories to show prime time.
CLASS INFORMATION
SCRATCHES – For exhibitors that need to scratch a class, this needs to be
done AT THE OFFICE PRIOR to the start of the class to receive a class /
judge fee refund. Otherwise, NO REFUNDS! If the class has started and
you scratch the class – NO Refunds. If a horse needs to scratch classes
due to medical reasons, this must be addressed with the show manager for
a full refund. There will not be a refund for stalls / bedding or office fees.
ADDS –An exhibitor may add to any class. To be in the draw, you must
enter prior to 5pm. If you add after the draw is posted, you will go first. An
exhibitor adding classes on Sunday, will be added AT the end of the draw for
that class.
Posting of draws will be done at the back gate and at the show office.
Every effort will be made to post the draw online no later than 8pm. The
PRIME TIME CLASSES
DERBY CLASSES
A horse rider combination may enter all eligible categories and pay only 1
judge fee (highest), or Enter a single category and pay that entry and judge
fee only. Please contact show secretary for more information.
Entries will close on Thursday at 5pm. The draw will be done at the Draw
Party on THURSDAY NIGHT.
No LATE FEE will be assessed for Derby Horses
MATURITY 7+ CLASSES
Entries will close on Thursday at 5pm. The draw will be done at the Draw
Party on THURSDAY NIGHT
No LATE FEE will be assessed for Maturity horses
THIS SHOW IS WCRHA AFFILIATE #2 AND IS A QUALIFYING SHOW FOR WESTERN REGIONAL AFFILIATE FINALS
BROOKSIDE SPECIALTY CLASSES & AWARDS
TRIPLE CROWN
Brookside is offering a special award for high scoring exhibitors To qualify the exhibitor MUST show at all 3 reining shows
held at Brookside - Rein for the Roses, WCRHA affiliate #6 (WCRHA #5 does not count), and the Summer Rein. The
award will be based on total score from all 3 shows and will be presented at the Summer Rein show in August.
DAILY DOUBLE
Brookside is offering a special award for high scoring exhibitors. To qualify the exhibitor MUST meet eligibility HOSTED by
Brookside - Rein for the Roses and Summer Rein. The award will be based on the total score from both shows and will be
presented at the Summer Rein show in August.
BROOKSIDE GREEN AS GRASS HORSE
This is an open class for 5&U horses in their first year showing. Any horse in their 1st calendar year (defined as January
1-December 31) of showing in reining. Non Pro riders are restricted to the rules of ownership as stated in the NRHA Non
Pro Conditions. See NRHA rulebook for reference. Horses to be shown in any age appropriate NRHA approved bit. Horses
shown in the bridle must be shown one handed or 2 handed in snaffle bit or hackamore. No jackpot. If you enter the show
pen to school, please let the announcer know. If schooling becomes excessive you will be excused.
THIS SHOW IS WCRHA AFFILIATE #2 AND IS A QUALIFYING SHOW FOR WESTERN REGIONAL AFFILIATE FINALS.
BROOKSIDE SHOW PARK USES THE
KISER DRAG ON ALL SHOW ARENAS
The Kiser DragMaster™ is the most
respected arena drag in the world. Used
and recommended by the AQHA, NRHA,
NCHA, NRCHA, APHA and many of the
industry’s top horsemen
SILKY’S BACK GATE PUB INVITES YOU TO JOIN US AT 3:15 FOR THE
142ND
RUNNING OF
THE KENTUCKY DERBY
PARADE OF HATS CONTEST $500 PRIZE MONEY TO BE GIVEN AWAY
NON PRO 7+ MATURITY
AND OPEN DERBY
EACH ENTRANT IN THE
DERBY WILL RECEIVE 2
FREE DINNER COUPONS.
WEAR YOUR HAT AT DINNER
FOR THE PARADE OF HATS.
SHOW SCHEDULE
***** Schooling signup closes at 5pm Tuesday ******
ARENA #1 WEDNESDAY MAY 4 2016 ∙ START TIME 7:30 AM large pen
PWWED PAID WARM UPS Arena # 1
Pre-sign up required.
-
$25
5minutes
******* ENTRIES CLOSE at 5pm Wednesday FOR CLASSES on Thursday
ARENA #1 THURSDAY MAY 5 2016 ∙ SHOW START TIME 7:30 AM ∙ large pen
PWTH PAID WARM UPS Arena # 2
CLASS
PATTERN
$25
5minutes
Start time 7:15am
ENTRY
FEE
JUDGES
FEE
classes start 7:30 am
1
MARES ONLY
13
$20
$20
No Video or Photo Fee
2
3
4
5
6
NRHA $500 Added Open
NRHA $400 Added Intermediate Open
NRHA $300 Added Limited Open
NRHA Rookie Professional jackpot
NRHA Prime Time Open jackpot (50+)
6
6
6
6
6
$50
$40
$30
$25
$25
$25
$25
$25
$25
$2
2-6 run
concurrent
* Qualifies for Triple Crown
7
8
NRHA $500 Add Novice Horse Non Pro L1
NRHA $500 Add Novice Horse Non Pro L2
8
8
$50
$50
$25
$25
9
WCRHA Green as Grass – 1 Year Only
(2 hands okay)
Brookside Green as Grass
st
(1 year only, 2 hands okay)
2
$20
$20
2
$20
$20
10
st
7,8 run
concurrent
* Qualifies for Daily Double
***** ENTRIES CLOSE at 5pm Thursday FOR ALL CLASSES on Friday *******
ENTRIES FOR MATURITY & FOR DERBY Close at 5pm. Must be entered to be included in draw party
ARENA #1 FRIDAY MAY 6 2016 SHOW START TIME 7:30 AM ∙ large pen
PWF PAID WARM UPS Arena # 2
CLASS
11
GELDINGS ONLY
PATTERN
11
Start time 7:15 am
$25
5minutes
ENTRY
FEE
$20
JUDGES
classes start 7:30 am
FEE
$20 No Video or Photo Fee
12
13
NRHA Snaffle / Hack 5&U Open jackpot
NRHA Snaffle Bit / Hackamore 5&U Non Pro
5
5
$25
$25
$25
$25
12-13 run
concurrent
14
15
NRHA $500 Add Novice Horse Open L1
NRHA $500 Add Novice Horse Open L2
2
2
$50
$50
$25
$25
14-15 run
concurrent
START TIME TO BE PUBLISHED and POSTED AT ENTRY GATE
Open Arena For 7+ Maturity & Derby Horses Only
START TIME OF MATURITY & DERBY TO BE DETERMINED & POSTED AT ENTRY GATE
AGED EVENT 7+ MATURITY (bridle, 1hand only)
101 NRHA Lvl 4 Open
$1000 Added
10
$100
$50
NON PRO DERBY
102 NRHA LVL 4 Non Pro
103 NRHA LVL 1 Non Pro
7
7
$250
$150
$50
$50
$2500 Added
$1500 Added
Page -1-
102,103
concurrent
SHOW SCHEDULE
ARENA #1 ∙ SATURDAY, MAY 7 2016 SHOW START TIME 7:30 AM
PWS PAID WARM UPS Arena # 2
PATTERN
CLASS
16
17
18
PWS
19
-
$25
5minutes
Start time 7:15 am
ENTRY
FEE
JUDGES
FEE
classes start 7:30 am
NRHA Rookie L1 Jackpot
4
ARENA #1 ∙ SATURDAY, MAY
7 2016$20
SHOW START TIME$20
7:30 AM
16 – 19 run
NRHA Rookie L2 Jackpot
4
$20
$20
NRHA
Prime
Time
Rookie
Jackpot
(50+)
4
$20
$20
PAID WARM UPS Arena # 2
$25
5minutesconcurrent
Start time 7:15 am
WCRHA Green Reiner (1hand only) jackpot
4
$20
$20
CLASS
20
NRHA 10 & Under Short Stirrup
PATTERN
14
JUDGES
FEE
$0
$20
$20
$20
$20
$20
$20
$20
$20
$20
$20
16
21
17
18
19
NRHA Rookie L1 Jackpot
Brookside Green as Grass Horse
NRHA Rookie L2
st Jackpot
(Horses 5&u, 1 year showing)
NRHA Prime Time Rookie Jackpot (50+)
WCRHA Green Reiner (1hand only) jackpot
20
START TIME TO BE PUBLISHED and POSTED AT ENTRY GATE
Open Arena For 7+ Maturity & Derby Horses Only
NRHA 10 & Under Short Stirrup
14
$10
$0
NON PRO MATURITY (bridle, 1hand only)
21
Brookside Green as Grass Horse
104 NRHA Lvl 4 Non
$1000 Added
st Pro
(Horses 5&u, 1 year showing)
Break
$20
$100
16 – 19 run
concurrent
$20
$50
START TIME TO BE PUBLISHED and POSTED AT ENTRY GATE
Open Arena For 7+ Maturity & Derby Horses Only
105 NRHA LVL 4 Open
$3500 Added
106
NRHA
LVL
1
Open
NON PRO MATURITY (bridle,$1500
1handAdded
only)
Break
5
10
classes start 7:30 am
RUNNING OF THE KENTUCKY DERBY on TV at Silky’s Back Gate Pub & Wine Down Bar
OPEN DERBY
104
4
5
4
4
4
ENTRY
FEE
$10
NRHA Lvl 4 Non Pro
7
7
$350
$150
$50
$50
105,106
concurrent
$1000 Added
10
$100
$50
***** ENTRIES CLOSE FOR CLASSES ON SUNDAY at 5 pm*****
RUNNING OF THE KENTUCKY DERBY on TV at Silky’s Back Gate Pub & Wine Down Bar
ARENA # 1 ∙ SUNDAY, MAY 8 2016 ∙ SHOW START TIME: 7:30 AM ∙ large pen
OPEN DERBY
PWS PAID WARM UPS Arena # 2
$25
5 minutes
Start time 7:15am
105,106
105 NRHA LVL 4 Open
$3500 Added
7
$350
$50
ENTRY
JUDGES
classes start 7:30 am
concurrent
106 NRHA LVL 1 Open
$1500 Added
7
$150
$50
CLASS
PATTERN
FEE
FEE
22
NRHA $500 Added Non *****
Pro ENTRIES CLOSE FOR
2 CLASSES
$50 ON SUNDAY at 5 pm*****
$25
22– 26 run
23
NRHA $400 Added Intermediate Non Pro
2
$40
$25
24
NRHA $200 Added
Limited
Pro
2 ∙ SHOW$20
$20
ARENA
# 1 Non
∙ SUNDAY,
MAY 8 2016
START TIME: 7:30 AM
∙ largeconcurrent
pen
25
NRHA Prime Time Non Pro Jackpot (50+)
2
$25
$25
26
NRHAWARM
Masters
NonArena
Pro Jackpot
(60+)
$25
$25
PWS
PAID
UPS
#2
-2
$25
5
minutes
Start time 7:15am
7
27
NRHA Green Reiner Level 1 (2 hands okay)
28
NRHA Green Reiner Level 2 (2 hands okay)
7
PATTERN
CLASS
22
NRHA $500 Added Non Pro
2
29
NRHA Youth 13 & Under
3
23
NRHA $400 Added Intermediate Non Pro
2
30
NRHA Youth 14-18
3
24
NRHA $200 Added Limited Non Pro
2
31
NRHA Youth Rookie
3
25
NRHA Prime Time Non Pro Jackpot (50+)
2
32
NRHA Unrestricted Youth
3
26
NRHA Masters Non Pro Jackpot (60+)
2
$20
ENTRY
$20
FEE
$50
$10
$40
$10
$20
$10
$25
$10
$25
$0
27,28 run
JUDGES
classes start 7:30 am
$0
concurrent
FEE
$25
$0
22– 26 run
$25
$0
concurrent
$20
29-32 run
$0
$25
concurrent
$0
$25
27
28
NRHA Green Reiner Level 1 (2 hands okay)
NRHA Green Reiner Level 2 (2 hands okay)
7
7
$20
$20
$0
$0
27,28 run
concurrent
29
30
31
32
NRHA Youth 13 & Under
NRHA Youth 14-18
NRHA Youth Rookie
NRHA Unrestricted Youth
3
3
3
3
$10
$10
$10
$10
$0
$0
$0
$0
29-32 run
concurrent
END OF THE SHOW – THANK YOU FOR COMING
ENTRY FORM CHECKLIST
FOR A COMPLETE NRHA ENTRY, THE FOLLOWING PAPERWORK MUST BE PROVIDED
[ ] Complete ALL information on entry form
[ ] Enclose copy of Rider & Owner’s 2015 WCRHA membership
card
[ ] Enclose photocopy of Rider & Owner’s 2015 NRHA cards
[ ] Enclose photocopy of Horse’s NRHA competition license
[ ] Verify your eligibility with NRHA before the show
[ ] Verify your eligibility with APHA before the show
Fax entries (must be confirmed with show secretary PRIOR to
sending) and if received after April 22, 2015 except for *Derby
only entries, will be considered late and late fee applied. NO Text
Entries accepted.
SHOW PLANNING:
STALLS
[ ] How many stalls___________________
[ ] Stall with _________________________________________
[ ] How many tack rooms? ______________
Café can be paid with a separate check or Cash. We do not accept
credit cards.
This is a BROOKSIDE Show. For Reservations for RV, Golf Cart,
Stalls, feed / shavings - contact Brookside (916) 682-1403 or
the show secretary
PRE-ENTRIES
Pre entries are due by April 26, 2016
LATE FEE applies for entries POSTMARKED after April 26, 2016.
PAYMENTS
Show Entries and all Brookside services, except CAFÉ can be paid
on one check or with cash at the show office. Please make check
payable to Brookside Show Park. We do not accept Credit Cards.
For Mailed in Entries, if provide an OPEN check, please make the
check payable to Brookside Show Park
IF You do NOT send a check – checks are required at time of
CHECK IN otherwise no number issued.
Mail entries to: Lorraine Kemper 11120 Bradley Ranch Rd
Elk Grove CA 95624
GENERAL SHOW RULES
This is a WCRHA Affiliate show #2 and will follow WCRHA general show
guidelines. This is a designated NRHA approved show, and current NRHA
rules shall prevail in all matters including, but not limited to: eligibility of horse
and rider, breaking of ties, use of illegal equipment, abuse or mistreatment of
any horse, unsportsmanlike conduct, and failure to pay.
PRIZE MONEY: Prize money will be paid per the NRHA Payback percentages
as noted in the NRHA 2016 Handbook once the show is validated by NRHA.
Prize monies will be mailed to owner of the horse at the address received
on the entry form. PLEASE BE SURE IT IS CORRECT. Ensure that the
correct SSN or TAX ID is provided.
SCHEDULE & CLASSES: Classes will be run according to the rules and
specifications listed in the NRHA 2016 Handbook.
MEMBERSHIPS: Membership in WCRHA is not required to participate
at the show; however to receive points to be applied to Year End awards
membership(s) is required and/or to qualify for the NRHA Western Region
Affiliate Finals.
NRHA membership is required for all classes designated NRHA.
present a current card OR purchase membership at the show.
MUST
WCRHA Green as Grass class is not jackpotted (no winnings paid out); also,
NRHA Youth classes are not jackpotted (no winnings paid out – NRHA Youth
points awarded)
PAID WARMUPS: Timeslots will be assigned on a First-Come, First Served
basis per postmark on entries received.
Each time slot is 5 minutes: 30 seconds to enter the pen, 4 minutes riding
time, 30 seconds to exit. Please be courteous to the next rider and exit
promptly when time is called. Additional times may be added at the gate
with announcer/time keeper. Horses entered in the show will have priority.
Non- showing horses, Rider must prepay or have open check on file with show
secretary and sign a waiver of liability
SHOW DAY WARMUPS
The 2nd ring will be available for PAID Warmups. If a horse is schooling in the
pen, there is a 5minute time allotted.
THE 1ST 5 time SLOTS ARE ALLOCATED TO THE 1ST 5 horses in the 1st
class
IF THEY DO NOT USE the TIME SLOTS – the ring is available.
 Priority will be given to horses entered in the show.
 Horses that are NOT entered in the show will be charged the warm up fee
PLUS the office ADMIN fee.
 “Walk-ups” will be taken when time slots are available. You must have an
open check in the office, or prepay, to get a walk-up schooling run.
 Paid warm-ups are scheduled in 5-minute increments unless otherwise
posted. This includes your time to enter and exit the pen (30 seconds in, 5
minutes riding, 30 seconds out). Please be courteous to the next rider and exit
promptly when your time is up.
NON SHOWING HORSES: Horses not entered in any class are allowed on
the show grounds under the following conditions: (1) brought with trainer –
AND are charged for stalls, schooling runs. 2) non-showing haul-in riders
must check in at the horse show office and sign a waiver and pay the day fee of
$20.00 and park in designated areas.
Thank you for Coming to the Show!
BACK #
as it appears on NRHA competition license
$________
Rider DOB_________NRHA # _________Exp. Date______ WCRHA # __________Exp Date______ [ ] Thurs [ ] Fri
[ ] Sat
[ ] Sun
2[ ] 3[ ] 4[ ] 5[ ] 6[ ] 7[ ] 8[ ] 9[ ] 10[ ] 11 [ ] 12[ ] 13[ ] 14[ ] 15[ ]
24 [ ]
25 [ ] 26[ ]
27[ ] 28[
OPEN DERBY (Age 4,5,6) :
[ ] 105 [ ] 107
NON PRO DERBY (Age 4,5,6) : [ ] 102 [ ] 103
23[ ]
] 29[ ] 30[ ] 31[ ] 32[ ]
[
] 101
NON PRO DERBY 7+ [ ] 104
OPEN DERBY 7+
8[ ]
9[ ]
27[ ] 28[
] 29[ ] 30[ ] 31[ ] 32[ ]
10[ ] 11 [ ] 12[ ] 13[ ] 14[ ] 15[ ]
OPEN DERBY (Age 4,5,6) :
Open CHECK #__________________
or Pay Café and Show fees Separately
* Pay at Show on One Check for All Services
(916) 682-1403 *
Pre Order R.V. spaces & Shaving
[ ] 105 [ ] 106
NON PRO DERBY (Age 4,5,6) : [ ] 102 [ ] 103
25 [ ] 26[ ]
5[ ] 6[ ] 7[ ]
For questions—Phone: (209)712-3836 or email: skylarkfarms@sbcglobal.net
Mail to: Anna-Lise Kozlowski— DERBY
25352 N Cherokee Lane
Galt CA 95632
Make checks payable to: BROOKSIDE
Saturday:
Friday:
19[ ]
] 4[ ]
20[ ] 21[ ] 22[ ] 23[ ] 24 [ ]
18 [ ]
3[
16 [ ] 17[ ]
]
2[
ANCILLARY CLASSES: 1[ ]
[ ] Open [ ] Non Pro [ ] Youth Rider DOB_________NRHA # _________Exp. Date______ WCRHA # _________ Exp Date______
EXHIBITOR #2 Name _____________________________________________ Relationship to owner ___________________
] 101
NON PRO DERBY 7+ [ ] 104
[
20[ ] 21[ ] 22[ ]
Saturday:
19[ ]
OPEN DERBY 7+
18 [ ]
Friday:
16 [ ] 17[ ]
ANCILLARY CLASSES: 1[ ]
[ ] Open [ ] Non Pro [ ] Youth
$_______
TOTAL DUE
$8/PER RUN
PHOTO/VIDEO
$25 horse
Late Entry Fee
$________
$________
$________
Office Fee per entry $_25.00__
per day per horse
Haul In @ $20.00
Drug Fee $5 / horse $__5.00__
$_______
_______
# Tack @$100 ea
Total
_______
# Stalls @ $120 ea
$________
$________
Warmup: [ ] Wed
EXHIBITOR #1 Name _____________________________________________ Relationship to owner ___________________
$________
FEES AND CHARGES:
Phone # ( ___) _______ Email:_________________________
Class/judge Total
Address:_____________________________________________________________ City, State,
Zip______________________________________________________
Co Owner _________________________________________ NRHA # ___________ Exp Date________
Owner____________________________________________ NRHA # __________ Exp Date________ Phone # ( ___) _______ Email:_________________________
OWNER INFORMATION
Breed_____________________ Registration #________________ TRAINER:_____________________________________Stable With:________________________
Horse Age:_____ Horse Sex: M G S (*If horse has been gelded—please be sure license is up to date)
Registered Name _______________________________________ NRHA License #____________________ Foal Year: _______
HORSE INFORMATION as it appears on NRHA competition license/Registration Papers
2016 REIN FOR THE ROSES SHOW (Affiliate #2, Derby, Maturity) 5/5—5/8
BY SIGNING BELOW, I AGREE to be bound by all applicable Federation Rules
and all items and provisions of this entry blank
Federation and the Competition and to hold them harmless with respect to claims for
Harm to me or my horse, and for claims made by others for any Harm caused by me
or my horse while at the Competition.
I have read the Federation Rules about protective equipment, including GR801 and, if
applicable, EV114, and I understand that I am entitled to wear protective equipment
without penalty, and I acknowledge that the Federation strongly encourages me to
do so while WARNING that no protective equipment can guard against all injuries.
If I am 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 represent that I have the requisite training,
coaching and abilities to safely compete in this competition.
I AGREE that if I am injured at this competition, the medical personnel treating my
injuries may provide information on my injury and treatment to the Federation on the
official USEF accident/injury report form.
Owner Print Name: _________________________________
Owner signature (MUST BE 18 or OVER TO SIGN)
X:______________________________________
Parent/Guardian Signature: _________________________
Rider B Print Name: ___________________________________
Rider B signature (MUST BE 18 or OVER TO SIGN)
X:______________________________________
Parent/Guardian Signature: _________________________
Rider A Print Name:___________________________________
Rider A signature (MUST BE 18 or OVER TO SIGN)
X:______________________________________
Phone: ____________________________________________
City/State/Zip: ______________________________________
Street: ____________________________________________
WCRHA #:________ NRHA_________
Coach Print Name: _________________________________
Coach signature (MUST BE 18 or OVER TO SIGN)
X:______________________________________
Please send copies of WCRHA and NRHA memberships
_____________________________________
___________________________________
______________________________
check box if payee is different than owner
___________________________
________________________________
Social Security:
Phone #:
State/Zip:_________________________
City:
Street:
Print name:
Prize money checks payable to:
PARENT/GUARDIAN MUST SIGN FOR A MINOR. SIGNATURES REQUIRED FOR OWNER AND RIDER.
BY SIGNING BELOW, I further AGREE to be bound by all applicable WCRHA, ORHA & NRHA Rules and all terms and provisions of this entry blank.
I AGREE in consideration for my participation in this Competition REIN FOR THE
ROSES/DERBY ON THE DERBY to the following:
I AGREE that “the Federation” and “Competition” as used herein includes the Licensee
and Competition Management, as well as all of their officials, officers, directors,
employees, agents, personnel, volunteers and Federation affiliates.
I AGREE that I choose to participate voluntarily in the Competition with my horse, as
a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as
parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse
sports and the Competition involve inherent dangerous risks of accident, loss, and
serious bodily injury including broken bones, head injuries, trauma, pain, suffering,
or death. (“Harm”).
I AGREE to hold harmless and release Brookside Horse Park, Silky’s Pub, and WCRHA
from all claims for money damages or otherwise for any Harm to me or my horse and for
any Harm of any nature caused by me or my horse to others, even if the Harm arises or
results, directly or indirectly, from the negligence of the Federation or the Competition.
I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting
from the negligence of the Federation or the Competition.
I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the
This document waives important legal rights. Read it carefully before signing.
RELEASE, ASSUMPTION OF RISK, WAIVER and INDEMNIFICATION
Open Derby
2015- Ollie Galligan
2010: Scott Nicolaides
2011: Buffy Trinchero
2012: Joey Pacini
2013: Cam Essick
2014: Stacy Hamilton
photos ©John O’Hara
Non Pro Derby
2015- Jim Grech & Cam Essick
2010: David Hanson
2011: Shawn Church
2012: John Irish,
Ricky Nicolazzi
2013: Tracer Gilson
2014: Mike Boyle
You need it? Brookside's GOT IT!
RV RESERVATIONS
Please call ahead for availability and reservations (916)682-1403
BROOKSIDE SHOW PARK
FEED AND BEDDING
CALL AHEAD AND PLACE YOUR ORDER
FACILITY OFFICE (916) 682-1403
SHELDON
FEED & SUPPLY
(916) 686-6400
8928 Grant Line Rd
11120 Bradley Ranch Road
Elk Grove, CA 95624
Relive the Show Experience
Who says
serious competition
can’t be fun?
www.BrooksideShowPark.com
photos by John O’Hara