Date & Location of Show you are entering: ______________________________
Rider Name: _______________________________________________________
SR ____ JR ____ (Birthdate if junior) _____________ Disabled: _______________
all riders under 18 must have a signed liability release attached
Horse Name: ____________________________ Date of Negative Coggins: ________
(Include copy of your horse’s Coggins with your entry) Name on Coggins must match the horse's name on the entry form
VADA/Nova member: YES NO
Address: _____________________________________________________________
Telephone Number: ______________ E-Mail Address: _________________________
Test: _________________________ Test: __________________________________
Cost per test: $30.00 VADA/Nova Members, $40.00 Non-Members, Pas de Deux $45/pair
(Note: Rider must be a current member to receive the discount)
Morven Grounds Fee: $20 per horse -
Required ONLY for the March and November 2012 shows at Morven Park
Cost for non-competing horse: $30 - Must contact secretary prior to show to register.
Total Amount for Entry: _____ Minus total “Volunteer Bucks” or vouchers enclosed: ____ = Total $ Amount Enclosed: ___________
Make check payable to VADA/Nova, Inc.
Note that members get priority in filling the available ride times for all VADA/Nova schooling shows. You may send in your membership with your show entry. Membership form available on the web site at www.vadanova.org
Sometimes accidents do happen. In case we need to get in touch with an emergency contact for you on the day of the show, please provide:
Emergency Contact Name: ____________________ Phone Number: ______________
- Entries are to be sent to the secretary for the show you are entering
- Ride Times: Available the Wednesday prior to the show at www.vadanova.org or from the show secretary
- Please bring your own boom box for all musical freestyles
- Training Level Musical Freestyle: VADA/Nova Training Level MFS will follow the same test and criteria as the US Pony
Club 2011 Training Level MFS. Guidelines for developing a TR MFS can be downloaded from the VADA/Nova website: www.vadanova.org. .These MFS will be allowed at VADA/Nova schooling shows only, not licensed
shows.
Entries which come in before the opening date will be considered received 3 days after the opening date.
VADA/Nova, Inc. Liability Release Form
I, the undersigned, understand that there are certain risks of injury and death inherent in all equine activities, including the named event below. Such risks include, but are not limited to: (i) the propensity of an equine to behave in dangerous ways which may result in injury to or the death of
participants in such activities (ii) the inability to predict an equine’s reaction to sound, movements,
objects, persons or animals, and (iii) the hazards of surface or subsurface conditions. I assume all risks of injury, death, and injury or damage to property, including equines, associated with participation in equine activities. I waive all rights to sue VADA, VADA/Nova, Inc., and/or any of their officers, directors, volunteers, employees and agents, the judges at this event, the owners or lessors of the facility where the event is held and/or any sponsor of this event for the injury to/or death of me or where applicable, the junior named below, and/or injury to property, including equines. I agree to indemnify and hold harmless the foregoing parties from and against any and all such claims of injury, death, or damage. This liability/release form is to be construed in accordance with, and to be as broad as permitting by the Equine Activity Liability/Act set forth by the Virginia Code.
Agreed ______________________________________Signature of rider
If rider is under 18, then parent or legal guardian must sign below to acknowledge the terms of this release form.
Signature of trainer/instructor is not acceptable.
Agreed __________________________________________Signature of parent or legal guardian
Name of rider (please print) _________________________________________
Address: ________________________________________________________
Phone: _________________________________________________________
Event: __________________________________________________________
Location: ________________________________________________________
Date: ___________________________________________________________
VADA/Nova's policy for all of their schooling shows is that all riders from Intro through
Grand Prix, whenever mounted, must be wearing a riding helmet which meets or
exceeds ASTM (American Society for Testing and Materials)/SEI (Safety Equipment
Institute) standards for equestrian use and carries the SEI tag. The headgear and
harness must be secured and properly fitted.
This applies to warm-up, competition and non-compete horses.