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PROVINCIAL CHAMPIONS GOLD ONLINE ENTRY
Autumn Classic Bronze & Gold Competitions + Manitoba Gold Provincial Championship
September 9th-11th 2022
ENTRY DEADLINE: No later than midnight Friday Aug 26th.
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 $8/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)
$7.00
$10.00
MHC Levy
(Mandatory)
$3.00
Friday Warm up in show ring ($35)
*
I prefer ring 1
I prefer ring 2
No preference
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
ENTRY FORMS
SHOW RESULTS
MEMBERSHIP
2023 MEMBERSHIP
DW NEWS
VOLUNTEERS
EDUCATION
CLUB HISTORY
EIA INFORMATION
LINKS
SPONSORSHIP
SPONSORSHIP INFORMATION
2022 SPONSORS
CONTACT
2023 Sponsors