Carolina Carriage Club Pleasure Driving Entry Form

Both pages of this form must be completed and sent to the competition for entry. This form may be printed and then handwritten. This form is located on www.carolinacarraigeclub.org.

Name of Competition: _____________________________________________________ Date:___________________ ___________________________________________

Name of Driver: ___________________________________ CCC #: ______________JR D.O.B.___________________

Address: _______________________________________________________________ City/State/Zip:___________________________________________

Day Phone: __________________________ Even. Phone: ___________________________

E-Mail: ____________________________________________

Name of Horse / Pony

Age

Height

Sex

Color

Breed

CLASS NUMBERS

Show Fees

Entry Fees: __________________________ Day Fee: ____________________________

Stabling Fees: ________________________

Competitors Party: ____________________ Camping Fees: ________________________

Other Fees: __________________________

TOTAL: ____________________________

Permission for Minor To Show (17 yrs & Under)

I hereby consent to the entry of my child (Name) ________________________

in this horse show and certify that I have read the foregoing representations

And statements and that the same may be deemed a part thereof, and hereby

Accept responsibility thereunder for the participation of said minor.

________________________________________________________________

Signature of Parent:

Office Use only: Coggins: Health Cert.: Stall Deposit Check:

Carolina Carriage Club Entry Agreement & Waiver

By entering a Carolina Carriage Club (hereinafter CCC) Competition and signing this entry blank as the Owner, Trainer, Driver, or Handler, and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of the CCC and the local rules of the competition. I agree to be bound by the Bylaws and Rules of the CCC and of the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules and agree to release and hold harmless the competition, the CCC, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the rules and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the CCC and/or the competition may use or assign photographs, videos, audios, cable-casts, or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport or the rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation.

Carolina Carriage Club Release, Assumption of Risk, Waiver and Indemnification

This document waives important legal rights. Read it carefully before signing.

I AGREE in consideration for my participation in this Competition {Carolina Carriage Club Pleasure Driving and Dressage Show} to the following:

I AGREE that I choose to participate voluntarily in the Competition with my horse, as a driver, handler, owner, 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 release the CCC and Harmon Field (hereinafter “HF”) 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, directly or indirectly, from the negligence of CCC or HF.

I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of CCC or HF.

I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) CCC and HF 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 at the Competition.

I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the CCC strongly encourages me to do so while WARNING that no protective equipment can guard against all injures.

If I am a parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to assume all of the obligations of this Release on the child’s behalf.

I AGREE that CCC and HF as used above includes all of their officials, directors, employees, agents, personnel, volunteers and affiliated organizations.

I represent that I have the requisite training, coaching and abilities to safely compete in this competition

BY SIGNING BELOW, I AGREE to be bound by all application CCC Rules and all terms and provisions of this entry blank.

Driver Handler Owner/Agent

(Mandatory) (Mandatory)

Signature: Signature:

Print Name: Print Name:

Parent/Guardian Signature: (Required if Driver/Handler is a minor): __________________________________________________________________________________________________________________

Print Parent/Guardian Name: ____________________________________________________________________________________ Emergency Contact Phone: ______________________________________