MONTH:                                                                                 AMT PAID: _______________

                                                                                                 MEMBER :     Y      OR      N

       TWIN VALLEY RIDERS CLUB “FUN DAY” ENTRY FORM

NAME OF RIDER: _______________________________     
ADDRESS: ____________________________________
NAME OF HORSE: ______________________________

                                                
CLASSES:     _____  Lead Line (1/2 price - $5.00 for all events)
                         _____ Children -12 & under (1/2 price - $5.00 for all events)
                         _____ Youth – 13 to 17 ($10.00 for all events)
                         _____  Adults – 18 to  29 ($15.00 for all events)
                         _____ Seniors – 30 to 49 ($15.00 for all events)
                         _____ Jack Benny – 50 and over ($15.00 for all events) 

$3.00 PER INDIVIDUAL EVENT

           GAME CLASSES – FOR POINTS           Time                  Placing                Points 

                _____ Barrel Racing                                ______               ______                ______

                _____ Flag Race                                     ______               ______                 ______

                _____ Pole Bending                                ______                ______                 ______

                _____ Key Hole                                      ______                 ______                ______

                _____ Jump Figure 8                               ______                 ______                ______

           NON-POINT EVENTS (time permitting)

               _____ Mystery Event                                ______                 ______              Non-Point          

               _____ Mystery Event                                ______                 ______              Non-Point

          TOTAL POINTS FOR YEAR-END AWARDS (MEMBERS ONLY)          ______

Point events will be tallied from all Fun Days on the same Horse-Rider combinations for paid members only. 
Each horse is scored separately.  A horse may be ridden only once per event in adult and youth age divisions.
A rider may ride more than one horse per event.  Riders are not to hit or spur the horse in front of the cinch
or they will be disqualified in the event.

Proof of negative Coggins for 2009 has been provided and a copy on file   Y  or   N    

I hereby release the Twin Valley Riders Club from any responsibility due to accident caused by horse or rider. 
I will not consume alcoholic beverages while participating in any events.

Signed, ______________________________  Participant

If under 18 years of age, must have a parent/legal guardian’s signature to participate.

Signed, ______________________________   Parent/Legal Guardian