Dressage Winnipeg Inc
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GOLD ONLINE ENTRY
Dressage Winnipeg Gold Competition Entry Form 2023
ONLY ONE HORSE PER ENTRY FORM
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Indicates required field
Please Select Show:
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June 23 - 25, 2023
August 11 - 13, 2023
September 8 - 10, 2023
Rider Information
Name of Rider
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First
Last
Address
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City
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Province
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Email
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Phone Number
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Country
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Canada
United States
Other
EC Gold License #
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MHC #
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DW/MHT/MPC/Westman/WD MEMB #
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Horse Information
Name of Horse
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Horses Breed
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Horses Age
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Horses Sex
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Mare
Gelding
Stallion
Horses colour
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Horses height
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Horse Recording # (Previously Passport #)
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Horse Owner Information
Name of Horses Owner
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Owners Phone #
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Owners Address
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City
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Province
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Country
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Canada
United States
Other
EC gold license #
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DW/MHT/MPC/Westman/WD MEMB #
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MHC #
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Person Responsible
Person Responsible
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EC license #
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EC license type
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Gold
Platinum
Rider Category
Category
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Junior
Open
Child
AA
English Dressage Tests
Check off the level/division, category and test (s) to be ridden.
Saturday
Sunday
Introductory Level Tests
Into Level, Sat ($30 each)
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Test A
Test B
Test C
Intro Level, Sun ($30 each)
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Test A
Test B
Test C
Training Level Tests
Training Level, Sat ($30 each)
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Test 1
Test 2
Test 3
Training Level, Sun ($30 each)
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Test 1
Test 2
Test 3
First Level Tests
First Level, Sat ($30 each)
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Test 1
Test 2
Test 3
First Level, Sun ($30 each)
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Test 1
Test 2
Test 3
Second Level Tests
Second Level, Sat ($30 each)
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Test 1
Test 2
Test 3
Second Level, Sun ($30 each)
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Test 1
Test 2
Test 3
Third Level Tests
Third Level, Sat ($30 each)
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Test 1
Test 2
Test 3
Third Level, Sun ($30 each)
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Test 1
Test 2
Test 3
Fourth Level Tests
Fourth Level, Sat ($30 each)
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Test 1
Test 2
Test 3
Fourth Level, Sun ($30 each)
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Test 1
Test 2
Test 3
Freestyles
FS Sat ($35)
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Training
First
Second
Third
Fourth
FS Sun ($35)
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Training
First
Second
Third
Fourth
FEI Division:
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Open
Child
Pony
Junior
Young Rider
FEI C/P/Jr/Yr Sat ($50 each)
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Preliminary
Team
Individual
FEI C/P/Jr/Yr Sun ($50 each)
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Preliminary
Team
Individual
FEI Small Tour
FEI Small Tour Sat($50 each)
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Prix St Georges
Intermediare 1
FEI Small Tour Sun ($50 each)
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Prix St Georges
Intermediare 1
FEI Medium Tour
FEI Medium Tour Sat ($50 each)
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Intermediate A
Intermediate B
Intermediare 2
FEI Medium Tour Sun ($50 each)
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Intermediate A
Intermediate B
Intermediare 2
FEI Big Tour, U25 Tour
FEI BIG TOUR, U25 TOUR Sat ($50 each)
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Intermediare 2
U25GP
GP
GP Special
I-A
I-B
FEI BIG TOUR, U25 TOUR Sun ($50 each)
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Intermediare 2
U25GP
GP
GP Special
I-A
I-B
FEI Freestyle
FEI FS Sat ($55)
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Pony
Junior
Young Rider
I-1
Medium Tour
Grand Prix
FEI FS Sun ($55)
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Pony
Junior
Young Rider
I-1
Medium Tour
Grand Prix
Stabling & Other Fees
Stabling Fees (Mandatory)
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$65 one night
$85 weekend
Tack Stall (RECOMMENDED) Aisles MUST be kept clear
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$48 one night
$68 weekend
Trailer In Fee if NOT Stabling ($12 per horse per day)
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0
1
2
3
Shavings $10/bag
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2 bags
3 bags
4 bags
5 bags
6 bags
Admin Fee
(Mandatory)
$45/ per weekend
Drug Test Fee
(Mandatory)
DC Levy
(Mandatory)
$8.00
$10.00
MHC Levy
(Mandatory)
Warm Up Ride
Medic Fee (Mandatory)
$3.00
$35.00
$30/weekend
MEMBERSHIPS (if necessary)
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Temp DW membership $75 (Or purchase regular membership for $55 Sr $45 Jr by completing a membership form)
Competitors who are not members of Dressage Winnipeg may purchase a DW temporary membership for ONE SHOW ONLY per year.
EC Temp Horse ID (in lieu of Passport), payable to EC directly - see Show Manager
Warm Up & Tack Stall Requests
Friday Warm up in show ring ($35)
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Ring 3
Warm up ring times
(Please choose between 1:00-7:00pm, half hour blocks available)
1st choice
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2nd choice
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3rd choice
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I'm sharing a warm-up with
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Stable or tack stall me with:
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Coach Information
Please List your Coach at the Competition and their EC Coaching Number or sign below if you are declaring you are Self Coached
ELECTRONIC SIGNATURE
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Name of coach:
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EC Coaching Number
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If you have a coach at the competition who is NOT EC Registered or Licensed you MUST pay the MHC Coaching Levy. If you do Not have a coach at the competition you are self coached and DO NOT pay the levy.
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$5.00
As the person responsible I hereby certify that the horse listed on this entry form has met the requirements of Article A519, Vaccinations (See rules of Equestrian Canada Section A, General Regulations Article A 519 Vaccinations) By signing this document electronically I agree that I consent to utilize electronic signatures in lieu of paper documents.
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DATE
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EC SPORT LICENSE #
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Comment
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Payment
PLEASE NOTE:
Payment, waiver form and negative Coggins test form part of this entry and must be sent to the show manager for your entry to be valid.
Please
take a minute to add up your fees from the totals above, and note the amount in the boxes below.
If paying by PayPal Add 4%
to this amount to cover credit card/merchant fees o
r
do not pay
4% fee and pay by e transfer to
[email protected]
NO CHEQUES ACCEPTED
Please fill in your totals in these fields before progressing and double check your addition
:
Class Entry Totals
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Subtotal:
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Stabling + Shavings Totals
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4% of Subtotal ONLY if paying with PayPal:
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Mandatory + Other Fees
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Total:
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NOTE YOUR TOTAL ON A SEPARATE PIECE OF PAPER - YOU WILL NEED TO ENTER YOUR TOTAL WHEN YOU GET TO THE PAYMENT PAGE. DO NOT USE YOUR BROWSER'S "BACK" BUTTON!!
Click Submit to proceed to the next step:
Submit
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