Entry Form 5th Annual Olympic Gold Medalist Leslie Law USEA Eventing Clinic

^5th Annual Olympic Gold Medalist Leslie Law USEA

Eventing Clinic

FALCONWOOD----WINNIE, TX

***Saturday - January 23, 2010 & Sunday – January 24, 2010

Mail registration to W J and Kelley Kays-Everett, 46718 IH 10 E. Winnie,Tx 77665 kkaysvet@aol.com 409-656-3822  fax 409-296-6087

Name of horse_______________________________ 

Name of rider________________________________Email_____________________

Address____________________________Phone #_________________

Greater Houston Combined Training Association Member?_______________

Adult rider member or other association?___________________________

Rider Level (circle one):   Beginner novice    Novice    Training   Preliminary / intermediate

FEES:

Private dressage jan 22 afternoon (very limited space)            $150.00________

Rider participation fee for weekend and June 2, 3:...................$400.00________

Deposit to hold spot until jan 5, then bal due........................... $100.00_______

Audit fee - $15                                                                                         _______

Stall fee for clinic....................................................................... $35.00   _______

Hookups for trailer $15 per night  ................................ ……$15.00/night _______

There will be a group dinner one night, fee to be announced later          _______

Mail your Coggins copy in with entry please!

(make checks payable to Kelley Kays-Everett)            TOTAL DUE: ________ 

We are planning a dinner with Mr. Law, details later.  

CURRENT COGGINS TEST REQUIRED – mail with entry

WARNING:

Under Texas law (Chapter 87, civil practice and remedies code), an equine professional is not liable for an injury to or to the death of a participant in equine activities resulting from the inherent risks of equine activities. 

I HEREBY RELEASE Falconwood (WJ Everett and Kelley Kays-Everett) from any liability and all claims of every kind (including costs, expenses, or attorney's fees)  that might result from damages, injuries or losses to my person or property during or in connection with the horse show, whether or not such damages, injuries or losses result directly or indirectly from negligent acts or omissions Falconwood (WJ Everett and Kelley Kays-Everett).  AND I ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND AGREE BY THE RULES.   

Rider’s signature_____________________________________date___________________________

Parent/Guardian if minor signature____________________________date______________________

DIRECTIONS:  From Houston, take I-10 E to Exit #829 and stay on feeder road past the  stop sign. Staying on the feeder drive past The Quality Inn  and Hunan Restaurant go approximately ½ mi. Turn Right at a group of Pine trees into the driveway of the Winnie Veterinary Clinic, go to the Gate and I will send you a code after you register .

Quality Inn Hotel 409-296-9292 or 1-800-4choice  mention Falconwood

Holiday Inn Express 409296-2866 or 1-800 Holiday