2019 halcyon farm, ltd. usef regional …^ } v z v pprize money ^ } v & o & a high perf....
TRANSCRIPT
HALCYON FARM MAY HORSE SHOW & KENTUCKY DERBY DAY FUNMay 4, 2019
Competition #245141 (USEF Regional I)Judges: Bradley Caine | Steward: Kathryn Meadows
Sharon Jodon
HALCYON FARM JUNE HORSE SHOW & BELMONT STAKES CLASSICSJune 8, 2019Competition #245142 (USEF Regional II)Judge: Joy Kloss | Steward: Kathryn Meadows
HALCYON FARM FALL HORSE SHOW & AUTUMN HUNTER DERBYSeptember 15, 2019Competition #327021(USEF Regional II)Judge: Alexandra Garrity | Steward: Faith McKay-Alicea
Barbara A. Kohr Cell: 717.503.6622 Email: [email protected] Fax: 717.432.1437
USEF Medal/ASPCA Maclay/ National PHA EquitationCPJHSA and PHSA Recognized.(PRE-ENTRY DEADLINE IS MONDAY BEFORE SHOW)
2019 HALCYON FARM, LTD. USEF REGIONAL HORSE SHOWS&
USHJA OUTREACH COMPETITIONS
Commonwealth Equestrian Productions
HALCYON RING FOOTING
Ring I - 240’ x 120’
Ring II - 190’ x 85’
Indoor Arena - 240’ x 72’
Lunging Area - 130’ x 80’
DIRECTIONS
FROM THE PENNSYLVANIA TURNPIKE:
mile on the right.
FROM YORK:
do the hill.
FROM MARYLAND/VIRGINIA:
OFFICIALS (All Shows)
Manager and Course Designer: Barbara A. Kohr
[email protected] (717) 503-6622
O cial Veterinarians: Green Glen Equine Hospital (717) 235-4312 (on call) Safety Coordinator: Sylvia Alfano Farrier: David Landol Farrier Service (on call) Secretaries: Sylvia Alfano
Robin JohnRenee Singley
EMT: Melinda Fultz George Turnbull
Limited stabling available. Stalls are $50/night and bedding is available for purchase. Stalls are permanent ith doors. Exhibitors are encouraged to pre-arrange stabling requests.
Licensee:
Prize Money
A High Perf. $750 $220 $60
A $500 $200 $50 Performance Hunter only
A Pony Hunter $400 $180 ---------
B $100 $160 $45
B Pony Hunter $50 $160 $45
C $250 $175 $40
C Regional --------- --------- $30
NR --------- --------- $25
All Models $30
$40
Outreach $20
Stalls are $50/night and bedding is available for purchase. Stalls are Permanent with doors. Exhibitors are encouraged to pre-arrange stabling requests.
2
Green Hunter 3’ 100-103 Green Hunter 3’3 105-108 Green Hunter 3’6” * 110-113 Green Hunter 3’9” * 115-118 3’3” Performance Hunter* 120-123 3’6” Performance Hunter* 125-128 3’3” Amateur-Owner 18-35* 147-150 3’3” Amateur-Owner 36 Up* 152-155 3’6” Amateur Owner 18-35* 157-160 3’6” Amateur Owner 36 Up* 162-165 3’3” Small Junior 15 & Under* 167-170 3’3” Small Junior 16-17* 172-175 3’3” Large Junior 15 & Under* 177-180 3’3” Large Junior 16-17* 182-185 3’6” Small Junior 15 & Under* 187-190 3’6” Small Junior 16-17* 192-195 3’6” Large Junior Hunt. 15 & Under* 197-200 3’6” Large Junior Hunter 16-17* 202-205
Small Green Pony 208-211 Medium Green Pony 214-217 Large Green Pony 220-223 Small Pony Hunter 226-229 Medium Pony Hunter 232-235 Large Pony Hunter 238-241
The last class number listed is the Under Saddle
. Small Hunter 300-303 Take2/TIP TB Hunter 3’ 305-308 Adult-Amateur 18-35 310-313 Adult-Amateur 36 and Older 315-318 Children’s Hunter 14 and Under 320-323 Children’s Hunter 15-17 325-328 Small/ Medium Children’s Pony 330-333 Large Children’s Pony 335-338 2’ USHJA Hunter 340-343 2’3” USHJA Hunter 345-348 2’6” USHJA Hunter 350-353 2’9” USHJA Hunter 355-358 3’ USHJA Low Hunter 360-363
Commonwealth Equestrian Productions
3
PRSR
T ST
DUS
POS
TAGE
PAID
HARR
ISBU
RG P
APE
RMIT
NO
583
Com
mon
wea
lth
Equ
estr
ian
Pro
duct
ion
s
15
-
2. PRE-ENTRIES CLOSE AT NOON THE MONDAY PRIOR TO EACH SHOW. Please enter online at horse showing.com or you can fax your
exhibitors will receive full refunds
-
entered.
-
processing.13. All dogs must be restrained on a leash.
15. Trophy or prize money and 8 ribbons will be awarded in all classes unless otherwise noted.16. Management reserves the right to cancel or combine any classes within USEF rules. Classes with four or more entries cannot be
cancelled.17. Minors who do not have a valid driver’s license which allows them to operate a motorized vehicle in the state in which they reside
-
measurements can be accommodated throughout the show day.
sharp disposable instruments.
Year Points to be awarded. be combined and run as one classic.
Ribbons and prize money to 12th place.
503. $250 Marshall and Sterling $25504. $250 Marshall and Sterling $25505. Marshall and Sterling Children’s Pony Hunter Classic $25506. Marshall and Sterling Bit of Straw Classic* $25 *Separate two round classic.
Baby Green Hunter 364-367
Low/Pre-Adult-Amateur Hunter 2’6” 385-388
406. Marshall and Sterling Junior Medal 3’6”407. WIHS Hunter Phase408. Dover Saddlery USEF Medal409. NHSAA/ASPCA Maclay Horsemanship410. Marshall and Sterling USEF Pony Medal411. M&S/MHSA Children’s Pony Medal 2’/2’6”
414. CPJHSA Adult Medal 3’415. M&S 2’6” Children’s Medal416. M&S 2’6” Adult Medal417. CPJHSA Low Medal
Commonwealth Equestrian Productions
4
5
Commonwealth Equestrian Productions
2019 SPECIAL EVENTS
$250 Halcyon Farm, Ltd. May Horse Show and “Outreach Derby for the Roses”
and Kentucky Derby Celebration
507.in the horse show. Fence heights to be approximately 2’, 2’6” and 3’ rider’s choice. First round will be a classic round and the second round over a shortened course will be the handy. Entry Fee: FREE Prize Money 1st-$75, 2nd-$50, 3rd-$40, 4th-$30, 5th-$20, 6th-$15, 7th-$10, 8th-$10 Ribbons to 8th place. **If less than six pre entries in the Derby it will not be held due to the consider-able effort that is required to host a hunter derby. Please enter the show and the derby by the pre-entry closing date.
$100 Halcyon June Belmont Hunter Bonus Stakes In addition to $250 Marshall and Sterling Children’s and Adult-Hunter Classics, any hunter section with six or more entries the third hunter round will be a “Belmont Bonus” Stake and the following prize money will be awarded: 1st-$40, 2nd-$30, 3rd-$20, and 4th-$10. No additional entry necessary.
$250 Halcyon Fall Outreach Hunter Derby 507.in the horse show. Fence heights to be approximately 2’, 2’6” and 3’ rider’s choice. First round will be a classic round and the second round over a shortened course will be the handy.
14
$20/Class. No USEF/USHJA membership is required to compete in classes listed on this page. Entries do not have to pay any USEF/USHJA fees. Please use the “Outreach” entry blank.
800-803
be penalized. Adults may ride ponies.
804-807
registered with the Jockey Club.
808-811
on the horse.
812-815Riders may not compete in any class where the fences exceed 2’3” at the same show. No cross-entry restric-
816-819Riders may not compete in any class where the fences exceed 2’6” at the same show. No cross-entry restric-
828-831
show.
who have not reached their 14th birthday as of December 1st of the current show year. CPJHSA Walk-Trot
give a pleasurable ride. Freedom Series riders must be 10 years or age or under for year-end awards.
13
Hors
e US
HJA#
Hors
e Na
me
Sex
Colo
rAg
eHe
ight
Gree
n Ye
arSi
ze
Prim
ary
Owne
r Nam
e
Owne
r Add
ress
USHJ
A #
DOB
Owne
r Em
ail A
ddre
ssOw
ner S
igna
ture
City
/Sta
te/Z
ipHo
me
Phon
eCe
ll Ph
one
Emer
genc
y Ph
one
Ride
r #1
Nam
e
Ride
r #1 A
ddre
ss
USHJ
A #
DOB
Ride
r #1
Emai
l Add
ress
Ride
r #1
Sign
atur
e
City
/Sta
te/Z
ipHo
me
Phon
eCe
ll Ph
one
Emer
genc
y Ph
one
Ride
r #1
Clas
ses
by N
umbe
rRi
der #
1 Se
ctio
ns
Ride
r #2
Nam
e
Ride
r #2 A
ddre
ss
USHJ
A #
DOB
Ride
r #2
Emai
l Add
ress
Ride
r #2
Sign
atur
e
City
/Sta
te/Z
ipHo
me
Phon
eCe
ll Ph
one
Emer
genc
y Ph
one
Ride
r #2
Clas
ses
by N
umbe
rRi
der #
2 Se
ctio
ns
ENTR
Y A
GR
EEM
ENT
FOR
OU
TREA
CH
CO
MPE
TITI
ON
By
ente
ring
this
OU
TRE
AC
H C
OM
PE
TITI
ON
and
sig
ning
this
ent
ry b
lank
as
the
Ow
ner,
Less
ee, T
rain
er, M
anag
er, A
gent
, Coa
ch, R
ider
, Driv
er, H
andl
er, V
aulte
r or L
onge
ur a
nd o
n be
half
of m
ysel
f an
d m
y pr
inci
pals
, rep
rese
ntat
ives
, em
ploy
ees
and
agen
ts, I
agr
ee th
at I
am s
ubje
ct to
the
Rul
es a
nd R
egul
atio
ns o
f Com
mon
wea
lth E
ques
trian
Pro
duct
ions
and
the
loca
l rul
es o
f the
com
petit
ion.
I
the
Rul
es.I
repr
esen
t tha
t I a
m e
ligib
le to
ent
er a
nd/o
r par
ticip
ate
unde
r the
Rul
es a
nd e
very
hor
se I
am e
nter
ing
is e
ligib
le a
s en
tere
d. I
als
o ag
ree
that
it is
a c
ondi
tion
of a
nd in
con
side
ratio
n of
prod
uct a
nd th
ey m
ay n
ot b
e us
ed in
suc
h a
way
as
to je
opar
dize
am
ateu
r sta
tus.
I h
ereb
y ex
pres
sly
and
irrev
ocab
ly w
aive
and
rele
ase
any
right
s in
con
nect
ions
with
suc
h us
e, In
clud
ing
any
clai
m
to c
ompe
nsat
ion,
inva
sion
of p
rivac
y, ri
ght o
f pub
licity
, or t
o m
isap
prop
riatio
n.
THIS
DO
CU
MEN
T W
AIV
ES IM
POR
TAN
T LE
GA
L R
IGH
TS.
REA
D IT
CA
REF
ULL
Y B
EFO
RE
SIG
NIN
G.
I AG
REE
in c
onsi
dera
tion
for m
y pa
rtici
patio
n in
this
Com
petit
ion
to th
e fo
llow
ing:
I A
GR
EE
I AG
REE
that
I ch
oose
to p
artic
ipat
e vo
lunt
arily
in th
e C
ompe
titio
n w
ith m
y ho
rse
as a
ride
r, dr
iver
, han
dler
, vau
lter,
long
eur,
less
ee, o
wne
r, ag
ent,
coac
h, tr
aine
r, or
as
pare
nt o
r gua
rdia
n of
a ju
nior
exh
ibito
r. I a
m fu
lly a
war
e an
d ac
know
ledg
e th
at h
orse
spo
rts a
nd th
e C
ompe
titio
n in
volv
e in
here
nt d
ange
rous
risk
s of
acc
iden
t, lo
ss, a
nd s
erio
us b
odily
inju
ry in
clud
ing
brok
en b
ones
, hea
d in
jurie
s, tr
aum
a,
pain
, suf
ferin
g or
dea
th.
(“H
arm
”).
I AG
REE
to h
old
harm
less
and
rel
ease
Com
mon
wea
lth E
ques
trian
Pro
duct
ions
and
the
Com
petit
ion
from
all
clai
ms
for
mon
ey d
amag
es o
r ot
herw
ise
for
any
Har
m to
me
or m
y ho
rse
and
for
any
harm
of a
ny n
atur
e ca
used
by
me
or m
y ho
rse
to o
ther
s, e
ven
if th
e H
arm
aris
es o
r res
ults
dire
ctly
or i
ndire
ctly
from
the
negl
igen
ce o
f Com
mon
wea
lth E
ques
trian
Pro
duct
ions
or t
he C
ompe
titio
n.I A
GR
EE to
exp
ress
ly a
ssum
e al
l ris
ks o
f Har
m to
me
or m
y ho
rse,
incl
udin
g H
arm
resu
lting
from
the
negl
igen
ce o
f Com
mon
wea
lth E
ques
trian
Pro
duct
ions
or C
ompe
titio
n.I A
GR
EE to
inde
mni
fy (t
hat i
s, to
pay
any
loss
es, d
amag
es, o
r cos
ts in
curr
ed b
y) C
omm
onw
ealth
Equ
estri
an P
rodu
ctio
ns a
nd th
e C
ompe
titio
n an
d to
hol
d th
em h
arm
less
with
resp
ect t
o cl
aim
s fo
r H
arm
to m
e or
my
hors
e, a
nd fo
r cla
ims
mad
e by
oth
ers
for a
ny H
arm
cau
sed
by m
e or
my
hors
e w
hile
at t
he C
ompe
titio
n.I h
ave
read
the
RU
LES
AN
D R
EG
ULA
TIO
NS
abo
ut p
rote
ctiv
e eq
uipm
ent,
and
I und
erst
and
I am
ent
itled
to w
ear p
rote
ctiv
e eq
uipm
ent w
ithou
t pen
alty
. I a
ckno
wle
dge
that
Com
mon
wea
lth E
ques
trian
P
rodu
ctio
ns s
trong
ly e
ncou
rage
s m
e to
wea
r pro
tect
ive
equi
pmen
t WA
RN
ING
that
no
prot
ectiv
e eq
uipm
ent c
an g
uard
aga
inst
all
inju
ries.
If
I am
the
pare
nt o
r gua
rdia
n of
a ju
nior
exh
ibito
r, I c
onse
nt to
the
child
’s p
artic
ipat
ion
and
AG
RE
E to
all
of th
e ab
ove
prov
isio
ns a
nd A
GR
EE
to a
ssum
e al
l of t
he o
blig
atio
ns o
f thi
s R
elea
se o
n th
e ch
ild’s
beh
alf.
I r
epre
sent
that
I ha
ve th
e re
quis
ite tr
aini
ng, c
oach
ing
and
abili
ties
to s
afel
y co
mpe
te in
this
com
petit
ion.
I A
GR
EE
BY
SIG
NIN
G B
ELO
W, I
AG
REE
to b
e bo
und
by a
ll ap
plic
able
com
petit
ion
rule
s an
d te
rms
and
prov
isio
ns o
n th
is e
ntry
bla
nk a
nd a
ll te
rms
and
prov
isio
ns o
f thi
s Pr
ize
List
. If
I am
sig
ning
Show
Fees
Qty.
Amou
ntTo
tal E
ntry
Fees
1$2
0.00
Total
Chec
k #__
____
____
_ or
Cre
dit C
ard E
nding
in __
____
____
____
__
Name
on C
heck
or C
redit
Car
d: __
____
____
____
____
____
____
___
Plea
se su
bmit C
redit
Car
d For
m wi
th en
try.
Pare
nt/G
uard
ian S
igna
ture
(Req
uired
if Ri
der/D
river
/Han
dler/V
aulte
r/Lon
geur
is a
mino
r) __
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Prin
t Par
ent/G
uard
ian N
ame:
____
____
____
____
____
____
____
____
____
____
____
____
___
Is
Rid
er/D
river
/Vau
lter a
U.S
. Citi
zen?
Y
es
No
Emer
genc
y Con
tact
#: __
____
____
____
____
____
____
____
____
__
Train
er
Addr
ess
Add
ress
City
/Sta
te/Z
ipTr
ainer
Sig
natu
re
Taxp
ayer
Nam
eAd
dres
s/City
/Sta
te/Z
ip
Cell #
Mail E
ntrie
s to:
Com
mon
wealt
h Equ
estri
an P
rodu
ction
s 17
2 Loc
ust G
rove
Roa
d, Di
llsbu
rg, P
A 17
019
Or Fa
x to 7
17-43
2-143
7 (m
ust in
clude
cred
it car
d for
m.)
OU
TR
EA
CH
EN
TR
Y B
LAN
K
Neg
ative
Cog
gin’s
Test
with
in o
ne ye
ar.
Mak
e C
heck
s P
ayab
le to
: Com
mon
wea
lth E
ques
trian
Pro
duct
ions
Onl
ine
ente
ring
at H
orse
show
ing.
com
Mai
l ent
ries
to: 1
72 L
ocus
t Gro
ve R
oad,
Dill
sbur
g, P
A 17
019
Fax
to 7
17-4
32-1
437
alon
g w
ith c
redi
t car
d fo
rm
8
WAITINGFORAD
12
Hors
e USE
F#Ho
rse N
ame
Sex
Colo
rAg
eHe
ight
Gree
n Ye
arSi
ze
Prim
ary O
wner
Nam
e
Owne
r Add
ress
USEF
#DO
BOw
ner E
Add
ress
City
/Sta
te/Z
ipHo
me P
hone
Cell P
hone
Emer
genc
y Pho
ne
Ride
r #1 N
ame
Ride
r #1 A
ddre
ss
USEF
#DO
BRi
der #
1 Em
ail A
ddre
ss
City
/Sta
te/Z
ipHo
me P
hone
Cell P
hone
Emer
genc
y Pho
ne
Ride
r #1 C
lasse
s by N
umbe
rRi
der #
1 Sec
tions
Ride
r #2 N
ame
Ride
r #2 A
ddre
ss
USEF
#AS
PCA
#DO
BRi
der #
2 Em
ail A
ddre
ss
City
/Sta
te/Z
ipHo
me P
hone
Cell P
hone
Emer
genc
y Pho
ne
Ride
r #2 C
lasse
s by N
umbe
rRi
der #
2 Sec
tions
Fede
ratio
n En
try
Agr
eem
ent
I hav
e re
ad th
e U
nite
d S
tate
s E
ques
trian
Fed
erat
ion,
Inc.
(the
“Fed
erat
ion”
) Ent
ry A
gree
men
t (G
R90
6.4)
as
prin
ted
in th
e P
rize
List
for [
inse
rt na
me
here
] (“C
ompe
titio
n”) a
nd a
gree
to a
ll of
its
prov
isio
ns. I
und
erst
and
and
agre
e th
at b
y en
terin
g th
is
Com
petit
ion,
I am
sub
ject
to F
eder
atio
n R
ules
, the
Priz
e Li
st, a
nd lo
cal r
ules
of t
he c
ompe
titio
n. I
agre
e to
wai
ve th
e rig
ht to
the
use
of m
y ph
otos
from
the
com
petit
ion,
and
agr
ee th
at a
ny a
ctio
ns a
gain
st th
e Fe
dera
tion
mus
t be
brou
ght i
n N
ew Y
ork
Sta
te.
This
doc
umen
t wai
ves
impo
rtant
lega
l rig
hts.
Rea
d it
care
fully
bef
ore
sign
ing.
I AG
RE
E in
con
side
ratio
n fo
r my
parti
cipa
tion
in th
is C
ompe
titio
n (H
alcy
on F
arm
, Ltd
. Hor
se S
how
s) to
the
follo
win
g:I A
GR
EE
that
the
“Fed
erat
ion”
and
“Com
petit
ion”
as
used
her
ein
incl
udes
the
Lice
nsee
and
Com
petit
ion
Man
agem
ent,
as w
ell a
s
I AG
RE
E th
at I
choo
se to
par
ticip
ate
volu
ntar
ily in
the
Com
petit
ion
with
my
hors
e, a
s a
rider
, driv
er, h
andl
er, v
aulte
r, lo
ngeu
r, le
ssee
, ow
ner,
agen
t, co
ach,
trai
ner,
or a
s pa
rent
or g
uard
ian
of a
juni
or e
xhib
itor.
I am
fully
aw
are
and
ackn
owle
dge
that
hor
se s
ports
and
th
e C
ompe
titio
n in
volv
e in
here
nt d
ange
rous
risk
s of
acc
iden
t, lo
ss, a
nd s
erio
us b
odily
inju
ry in
clud
ing
brok
en b
ones
, hea
d in
jurie
s,
traum
a, p
ain,
suf
ferin
g, o
r dea
th. (
“Har
m”)
. I A
GR
EE
to h
old
harm
less
and
rele
ase
the
Fede
ratio
n an
d th
e C
ompe
titio
n fro
m a
ll cl
aim
s fo
r mon
ey d
amag
es o
r oth
erw
ise
for a
ny
Har
m to
me
or m
y ho
rse
and
for a
ny H
arm
of a
ny n
atur
e ca
used
by
me
or m
y ho
rse
to o
ther
s, e
ven
if th
e H
arm
aris
es o
r res
ults
/re
sulte
d, d
irect
ly o
r ind
irect
ly, fr
om th
e ne
glig
ence
of t
he F
eder
atio
n or
the
Com
petit
ion.
I AG
RE
E to
exp
ress
ly a
ssum
e al
l ris
ks o
f Har
m to
me
or m
y ho
rse,
incl
udin
g H
arm
resu
lting
from
the
negl
igen
ce o
f the
Fed
erat
ion
or th
e C
ompe
titio
n.I A
GR
EE
to in
dem
nify
(tha
t is,
to p
ay a
ny lo
sses
, dam
ages
, or c
osts
incu
rred
by)
the
Fede
ratio
n an
d th
e C
ompe
titio
n an
d to
hol
d th
em h
arm
less
with
resp
ect t
o cl
aim
s fo
r Har
m to
me
or m
y ho
rse,
and
for c
laim
s m
ade
by o
ther
s fo
r any
Har
m c
ause
d by
me
or m
y ho
rse
whi
le a
t the
Com
petit
ion.
I ha
ve re
ad th
e Fe
dera
tion
Rul
es a
bout
pro
tect
ive
equi
pmen
t, in
clud
ing
GR
801
and,
if a
pplic
able
, E
V11
4, a
nd I
unde
rsta
nd th
at I
am e
ntitl
ed to
wea
r pr
otec
tive
equi
pmen
t with
out p
enal
ty, a
nd I
ackn
owle
dge
that
the
Fede
ratio
n st
rong
ly e
ncou
rage
s m
e to
do
so w
hile
WA
RN
ING
that
no
prot
ectiv
e eq
uipm
ent c
an g
uard
aga
inst
all
inju
ries.
If I
am a
par
ent o
r gu
ardi
an o
f a ju
nior
exh
ibito
r, I c
onse
nt to
the
child
’s p
artic
ipat
ion
and
AG
RE
E to
all
of th
e ab
ove
prov
isio
ns a
nd A
GR
EE
to a
ssum
e al
l of t
he o
blig
atio
ns o
f thi
s R
elea
se o
n th
e ch
ild’s
beh
alf I
repr
esen
t tha
t I h
ave
the
requ
isite
trai
ning
, coa
chin
g an
d ab
ilitie
s to
saf
ely
com
pete
in th
is c
ompe
titio
n.I A
GR
EE
that
if I
am in
jure
d at
this
com
petit
ion,
the
med
ical
per
sonn
el tr
eatin
g m
y in
jurie
s m
ay p
rovi
de in
form
atio
n on
my
inju
ry a
nd
BY
SIG
NIN
G B
ELO
W, I
AG
RE
E to
be
boun
d by
all
appl
icab
le F
eder
atio
n R
ules
and
all
term
s an
d pr
ovis
ions
of t
his
entry
bla
nk. I
f I a
m s
igni
ng a
nd s
ubm
ittin
g th
is A
gree
men
t ele
ctro
nica
lly, I
ack
now
ledg
e th
at m
y el
ectro
nic
sign
atur
e sh
all h
ave
the
sam
e va
lidity
,
Show
Fee
sQt
y.Am
ount
USEF
Fee
1$2
3.00
USHJ
A Zo
ne S
uppo
rt Fe
e$2
.00$2
0.00
Othe
r Fee
s
Late
/ Pos
t Ent
ry F
eePa
ymen
t Inf
o: C
heck
# __
____
____
_
CRED
IT C
ARDS
ACC
EPTE
D.
A 2%
CON
VENI
ENCE
FEE
WIL
L BE
CH
ARGE
D.
ALL
CHEC
KS R
ETUR
NED
BY T
HE
BANK
WIL
L BE
CHA
RGED
$30.
Pare
nt/G
uard
ian S
igna
ture
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
(Req
uired
if Ri
der/D
river
/Han
dler/V
aulte
r/Lon
geur
is a
mino
r)
Prin
t Par
ent/G
uard
ian N
ame:
____
____
____
____
____
____
____
____
____
____
__ I
s Rid
er/D
river
/Vau
lter a
U.S
. Citi
zen?
Y
es
No
Emer
genc
y Con
tact
#: __
____
____
____
____
____
____
___
Train
er
Addr
ess
USEF
#Em
ail A
ddre
ss
City
/Sta
te/Z
ip
Taxp
ayer
Nam
eAd
dres
s/City
/Sta
te/Z
ip
Cell #
SSN
or T
IN
USE
F R
EGIO
NA
L SH
OW
ENTR
Y B
LAN
K
Mak
e C
heck
s P
ayab
le to
: Com
mon
wea
lth E
ques
trian
Pro
duct
ions
Onl
ine
ente
ring
at H
orse
show
ing.
com
Mai
l Ent
ries
to: 1
72 L
ocus
t Gro
ve R
oad,
Dill
sbur
g, P
A 17
019
Fax
to 7
17-4
32-1
437
Pho
ne: 7
17-5
03-6
622
-- S
how
Day
Pho
ne: 7
17-8
05-0
559
Train
er S
igna
ture
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____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Owne
r Sig
natu
re __
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Ride
r Sig
natu
re __
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Ride
r #2 S
igna
ture
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
USEF Competition Name: USEF#:Competition Division(s) and Rating(s):
Starting January 1, 2019, if you are a USEF Competing Member 18 years of age or older you are required to complete the core Safe Sport Training within 30 days of activating your membership.
If you do not complete the training, you are ineligible to participate in all USEF activities including competitions.
TAKE the SAFE SPORT TRAINING at USEF.org by logging into your member dashboard.
USEF SAFE SPORT TRAINING REQUIRMENT
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