Entry Form – MCTA Starter HT at Tranquillity Manor Farms

Horse Information

Horse Name *

Layout

Horse Gender *

Mare
Gelding
Stallion

TIP # (Thoroughbred Incentive Program)

Select Division *

Introductory - 2023 Intro Test A, Stadium mostly Xs and Cross Country up to 18” of mostly logs/poles near the rings, will have terrain, but will not cross the driveway.
Elementary - 2022 USEA Starter Test A , Stadium and Cross Country up to 24” will have terrain and options, but will not cross the driveway.
Starter - 2022 USEA Starter Test A, Stadium and Cross Country up to 2’3” may include an up bank, terrain, a faux ditch, and option at water.
Beginner Novice - 2022 BN Test A, Stadium and Cross Country up to 2’7”
Novice - 2022 Novice Test A, Stadium and Cross Country up to 2’11”

Rider Information

Rider Name *

I am a current member of:

MCTA
US Pony Club

Pony Club Name

Rider Division *

Senior/Open
Junior (18 and under)

Birth Year (if Junior) *

Rider Address *

Address Line 1

City

State

Zip Code

Email *

Email

Confirm Email

Phone *

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Emergency Contact Name *

Emergency Phone *

Payment Information

Paying with MCTA Volunteer Bucks? *

No, I'm not using Bucks
Partial payment with Bucks
Full payment with Bucks

Select Entry Fee *

Non-MCTA Member HT Entry Fee - $ 150.00
MCTA Member HT Entry Fee - $ 120.00
Combined Test divisions - $ 70.00
Dressage only (Test of Choice) - $ 35.00
Dressage only (for 2 tests) - $ 60.00

Select Entry Fee Item *

Non-MCTA Member HT Entry Fee - $ 150.00
MCTA Member HT Entry Fee - $ 120.00
Combined Test divisions - $ 70.00
Dressage only (Test of Choice) - $ 35.00
Dressage only (for 2 tests) - $ 60.00

MCTA Volunteer Bucks Amount (mail to Secretary) *

Redeemable in full amount only (no change is given)

Total Fees to be Paid *

(Enter the sum of your selected Entry Fee minus the MCTA Volunteer Bucks you will send in)

Total Fees to be Paid

Price: $ 0.00

Total

$ 0.00

Refunds: Provided if requested before the closing date less a $25 office fee. No refunds after the closing date or if the event is canceled. Tentative Time Schedule: Sat. 10/7 4pm: Cross country course open for walking. Sunday 10/8: Dressage 8am - Stadium 9:45 am - Cross country 10am. Awards: Trophies and Overall ribbons to 6th place. Ribbons awarded if there are 3 or more starters per division. Trophies are awarded to MCTA members, if you want scores to be considered for trophies you MUST join BEFORE the closing date. MCTA members will also qualify for an MCTA high point award for each division. TIP prizes will be awarded for each division.

Important Information:

Vet and Farrier on call. * Limited water, bring your own. * Food available. * No unleashed dogs. * Event will follow USEF rules for Eventing * Body protectors required for XC and Helmets required when mounted * Organizer reserves the right to divide divisions into sections based on age and experience. * Medical armbands are recommended. * No standing martingales. * We are using Paper Pinnies, you will need a pinny holder!!

RELEASE OF LIABILITY AND AGREEMENT OF ENTRY:

Every entry at this competition shall constitute agreement and affirmation that all participants (including owner, leasee, trainer, rider, handler and the horse) for themselves and their agents (1) shall be subject to the local rules of the competition; (2) represent that every horse and rider is eligible as entered (3) agree to be bound by the rules of the competition, and will accept as final the decision of the Ground Jury on any question arising under said rules, and agree to hold the competition harmless for any action taken and (4) agree that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk of serious injury or death, and by participating they expressly assume any and all risks of injury and loss, and they agree to indemnify and hold the competition and their officials, employees and agents harmless from and against all claims including for any injury or loss suffered during or in connection with the competition, whether or not such injury or loss resulted, directly or indirectly, from the negligent acts or omissions of said owners, officials, managers, employees or agents of this competition.

RELEASE

I understand that this is a high-risk sport and am participating at my own risk. I hereby assume this risk and further do hereby release and hold harmless the Organizer, the Organizing Committee, judges and officials, the host of this event or horse trial and the owners of any property on which the event or trial is to be held, from all liability from negligence resulting in accidents, damage, injury or illness to myself and to my property, including the horse or horses which I will compete at this event or trial.

Rider's Signature (or Parent/Guardian if under 18) *

Upload Coggins Test here:

Click or drag a file to this area to upload.

Electronic Coggins or photo must be received or a time will NOT be assigned (may also be emailed or texted to secretary)..

Additional Comments

Entry Options

All entries are submitted online via this form.
Payment Types - Credit, Debit, PayPal. If applicable, mail MCTA Volunteer Bucks to Secretary.
Coggins - upload here with entry form, or if needed email/text a photo of Coggins to secretary w/ Rider Name.

Secretary: Melissa Fieldhouse, StarterHT@mdcta.com, 443-974-0712,

2520 Fairmount Road Hampstead MD 21074-1432