MeCTA Event Entry Form

EVENT:_____________________________________________

DIVISION:____________________________ DATE:__________

Name of Rider:_______________________________________   Jr:____ Sr:____

   Address: __________________________________________________________

         __________________________________________________________

   Telephone #: _____________________  E-Mail:_____________________________

   Year of Birth: ______________MECTA Membership Number: _____________

Name of Horse: _____________________________________________________

It is important that you enter your horse’s name consistently from show to show so that you can be credited for Year-End awards.

    Age: _______Height: ________

    Breed: ___________________________Color: _______________________

    Sex:  Mare: _____     Gelding: _____     Stallion: _____

Name of Owner if different from rider: ___________________________________________

RELEASE:

All competitors must read and sign below:

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

Signature: __________________________________________________

(parent or guardian if under 18)

Please Enclose:1.  Entry Fee      ___________

  2.  Other fees    ___________

(such as stabling, if offered)

Total of check     ___________

      No MeCTA number?  In a separate check:  3. Non-Member fee  $5.00 payable to MeCTA

  4.  Copy of negative Coggins

Your entry is incomplete without the Coggins!