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PROVINCIAL CHAMPIONS GOLD ONLINE ENTRY
Autumn Classic Bronze & Gold Competitions + Manitoba Gold Provincial Championship
September 8th-10th 2023
ENTRY DEADLINE: No later than midnight Friday Aug 25th.
ONLY ONE HORSE PER ENTRY FORM
*
Indicates required field
Name of Rider
*
First
Last
age of rider if under 18
*
Address
*
City
*
Province
*
Email
*
Phone Number
*
Country
*
Canada
United States
Other
EC Gold License #
*
MHC #
*
DW/MHT/MPC/Westman/WD MEMB #
*
Name of Horse
*
Horses Breed
*
Horses Age
*
Horses Sex
*
Mare
Gelding
Stallion
Horses colour
*
Horses height
*
Horse Recording # (Previously Passport #)
*
Name of Horses Owner
*
Owners Phone #
*
Owners Address
*
City
*
Province
*
Country
*
Canada
United States
Other
EC gold license #
*
DW/MHT/MPC/Westman/WD MEMB #
*
MHC #
*
Person Responsible
*
EC license #
*
EC license type
*
Gold
Platinum
Category
*
Junior
Adult Amateur
Open
(note that AAs must have official AA status from Equine Canada. If competing with a temporary EC Sport license you may not enter as an AA)
Check off the Level/Division, Category and Test (s) to be ridden:
Qualifying score (Minimum 55% at level competing at, please note the show and judge where the qualifying score as received)
*
Saturday
Sunday
Introductory
INTRO Sat ($100 both tests)
*
Test C
INTRO SUN ($100 both tests)
*
Test D
Training Level
Training Sat ($100 both tests)
*
Test 2
Training Sun ($100 both test)
*
Test 3
First Level
1st Sat ($100 both tests)
*
Test 2
1st Sun ($100 both tests)
*
Test 3
Second Level
2nd Sat ($100 both tests)
*
Test 2
2nd Sun ($100 both test)
*
Test 3
Third Level
3rd Sat ($100 both test)
*
Test 2
3rd Sun ($100 both tests)
*
Test 3
Fourth Level
4th Sat ($100 both tests)
*
Test 2
4th Sun ($100 both tests)
*
Test 3
Freestyles
FS Saturday Only ($55)
*
First
Second
Third
Fourth
FEI Division:
*
None
Child
Pony
Junior
Young Rider
FEI C/P/Jr/Yr Sat ($140 both tests)
*
Team
FEI C/P/Jr/Yr Sun ($140 both tests)
*
Individual
FEI Small Tour
FEI Small Tour Sat($140 both tests)
*
Prix St Georges
FEI Small Tour Sun ($140 both tests)
*
Intermedaite 1
FEI Medium Tour
FEI Medium Tour Sat ($140 both tests)
*
Intermediate A
FEI Medium Tour Sun ($140 both tests)
*
Intermediate B
FEI Big Tour
FEI GP Sat ($140 both tests)
*
Grand Prix
FEI GP Sun ($140 both tests)
*
Grand Prix Special
FEI Freestyle
FEI FS Saturday Only ($75)
*
Pony
Junior
Young Rider
I-1
Grand Prix
Stabling Fees (Mandatory)
*
$85 weekend
Tack Stall (Recommended)
*
$68 weekend
Unserviced Camping Fee ($10.50 per night)
*
0 nights
1 night
2 nights
Shavings $11/bag
*
2 bags
3 bags
4 bags
5 bags
6 bags
Admin Fee
(Mandatory)
Medic Fee
(Mandatory)
$45.00
$30.00
Drug Test Fee
(Mandatory)
DC Levy
(Mandatory)
$8.00
$10.00
MHC Levy
(Mandatory)
$4.00
Friday Warm up in show ring ($35)
*
Ring 3
Warm up ring times
(Please choose between 1:00-7:00pm, half hour blocks available)
1st choice
*
2nd choice
*
3rd choice
*
I'm sharing a warm-up with
*
Stable or tack stall me with:
*
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
*
Name of Coach
*
EC Coaching Number
*
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.
*
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.
*
DATE:
*
EC SPORT LICENSE #
*
Any other notes to the show manager?
*
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
dressagewinnipegtreasurer@gmail.com
NO CHEQUES ACCEPTED
Please fill in your totals in these fields before progressing and double check your addition
:
Class Entry Totals
*
Subtotal:
*
Stabling Totals
*
4% of Subtotal:
*
Other Fees
*
Total:
*
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
HOME
SHOWS
Show Dates
PRIZE LIST
Payment Page
Stabling & Schedules
SHOW RESULTS
Entries Closed
MEMBERSHIP
September 2023 Rider Spotlight
August 2023 Rider Spotlight
July 2023 Rider Spotlight
June 2023 Rider Spotlight
2023 MEMBERSHIP
DW NEWS
VOLUNTEERS
SCHOLARSHIPS/GRANTS
2023 Scholarships
CLUB HISTORY
EIA INFORMATION
LINKS
SPONSORSHIP
2023 Sponsors
SPONSORSHIP INFORMATION
CONTACT
SHOW RESULTS