Connecticut Dressage & Combined Training Association
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CDCTA Horse Show Registration
Please complete the following information.
Only
one
horse and rider combination per form.
*
Indicates required field
Rider Name
*
First
Last
Select One
*
CDCTA Member
Non-Member
Please Choose One
*
Adult Amateur
Junior
Open
CDCTA Member Number
*
USDF Rider Number
*
Required if participating in the USDF Regional Schooling Show Awards Program
Street/City/State/Zip
*
Street, City, State & Zip
Date of Birth
*
Email
*
Trainer Name
*
Phone Number
*
Trainer E-mail
*
Emergency Contact
*
Name & Relationship to rider
Barn/Group Name (CDCTA Barn of the Year)
*
Emergency Contact Phone #
*
Horse's Name
*
Breed
*
Color
*
Horse's Gender:
*
Mare
Gelding
Stallion
Height
*
Horse's Year of Birth
*
Horse's Owner
*
Horse USDF Number
*
Required if participating in the USDF Regional Schooling Show Awards Progam
Owner's E-mail
*
Owner USDF Number
*
Required if participating in the USDF Regional Schooling Show Awards Program
Owner's Phone
*
CDCTA keeps TIP Cards, Coggins & Rabies Certificates on file for the season.
IF
CDCTA has
current
certificates on file, they do not need to be submitted again.
Coggins File Upload
*
Max file size: 20MB
Rabies File Upload
*
Max file size: 20MB
If Rabies information is a separate certificate not on Coggins.
Thoroughbred Incentive Program Participant?
*
No
Yes
T.I.P. Card Upload
*
Max file size: 20MB
If CDCTA does not already have a copy.
Class One:
*
CT: Training
CT: Novice
CT: Beginner Novice
CT: Adv. Elementary
CT: Elementary
CT: Pre-Elementary
Lead Line Walk Only
Lead Line Walk/Trot
Introductory Test A
Introductory Test B
Introductory Test C
Training Level Test 1
Training Level Test 2
Training Level Test 3
First Level Test 1
First Level Test 2
First Level Test 3
Second Level and Above Test of Choice
Western Dressage Test of Choice
Musical Freestyle Test of Choice
USEA Test of Choice
Class Two:
*
--------------------------
Lead Line Walk Only
Lead Line Walk/Trot
Introductory Test A
Introductory Test B
Introductory Test C
Training Level Test 1
Training Level Test 2
Training Level Test 3
First Level Test 1
First Level Test 2
First Level Test 3
Second Level and Above Test of Choice
Western Dressage Test of Choice
Musical Freestyle Test of Choice
Class Three:
*
--------------------
Introductory Test A
Introductory Test B
Introductory Test C
Training Level Test 1
Training Level Test 2
Training Level Test 3
First Level Test 1
First Level Test 2
First Level Test 3
Second Level and Above Test of Choice
Western Dressage Test of Choice
Musical Freestyle Test of Choice
Test of Choice: Class One
*
Test of Choice: Class Two
*
Test of Choice: Class Three
*
If Class is "Test of Choice", please write which test you would like to ride in the space provided.
Electronic Signature
I consent and agree that use of a key pad, mouse or other device to select an item, button, icon or similar act/action while using any electronic service CDCTA, Treasure Hill Farm or their agents offers, or in accessing or making any transactions regarding any agreement, acknowledgement, consent, terms, disclosures or conditions constitutes my signature, acceptance and agreement as if actually signed by me in writing. Further, I agree that no certification authority or third party verification is necessary to validate my electronic signature below; and that the lack of such certification or third party verification will not in any way affect the enforceability of my signature or resulting contract between me and CDCTA, Treasure Hill Farm or their agents. I understand and agree that my e-Signature executed in conjunction with the electronic submission of this form shall be legally binding and such transaction shall be considered authorized by me.
**If you decline, a completed entry/release form with the rider's or guardian's HAND-WRITTEN signature must be submitted via e-mail prior to riding with CDCTA on Treasure Hill Farm property.
Choose One
*
I Consent
I Decline
CDCTA Schooling Dressage and Combined Training Show
Please sign the Release of Liability form. Unsigned entries cannot be accepted.
RELEASE OF LIABILITY
READ AND UNDERSTAND THIS BEFORE YOU SIGN IT!
In consideration for the Rider being permitted to participate in a horse show sponsored or organized by The Connecticut Dressage and Combined Training Association, Inc. (“CDCTA”) on July 16, 2023 at, Treasure Hill Farm, 523 Old Colchester Road, Salem, CT 06420, CT, the Rider and his/her parents (if Rider is under 18 years of age) agree that CDCTA, Treasure Hill Farm, the judges(s), and their agents, members, volunteers and assistants shall not be liable for, and agree to hold them harmless from, any accident, personal injury, death or property damage that may be sustained by any person or entity, including without limitation the Rider, as a result in whole or in part from the Rider’s participation in the show. This agreement is binding on the Rider and his/her parents whether or not said accident, personal injury, death, or property damage is due in whole or in part to the negligence of CDCTA, Treasure Hill Farm, the judge(s) or any of their agents, members, volunteers, or assistants. The Rider and his/her parents (if Rider is under 18 years of age) agree to defend and indemnify CDCTA, Treasure Hill Farm, the judge(s) and their agents, members, volunteers and assistants for any claims, demands, or suits arising from the Rider’s participation in the show, including without limitation those arising in whole or in part from the negligence of CDCTA, Treasure Hill Farm, the judge(s) or their agents, members, volunteers or assistants.
Rider Signature in Typed First and Last Name (Guardian Must Sign if Rider is Under 18 Years of Age):
*
Liability Waiver signed on
*
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Connecticut Dressage and Combined Training Association (“CDCTA”) and
Treasure Hill Farm
(“THF”) has put in place preventative measures to reduce the spread of COVID-19; however, CDCTA and THF cannot guarantee that you will not become infected with COVID-19. Further, attending CDCTA and THF could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending CDCTA and THF and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at CDCTA and THF may result from the actions, omissions, or negligence of myself and others.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at CDCTA and THF or participation in activities. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless CDCTA and THF, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of CDCTA and THF, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any CDCTA and THF program.
Rider Signature in Typed First and Last Name (Guardian Must Sign if Rider is Under 18 Years of Age):
*
COVID19 release signed on:
*
Proceed to Payment Information
Home
About
Ernie
Newsletter
Events
Horse Shows
>
Show Calendar
Results
Clinics & Lectures
Year End Awards
2024 Year End Awards Luncheon
Eligibility & Awards
Combined Training
Special Awards
Eventing
Dressage
Past Award Winners
Resources
Current Dressage Tests
Contact
Membership
Become a Member
Scholarships
Volunteer
>
Volunteer Recognition Program
CDCTA Sponsored Teams
>
Junior/Young Rider Dressage Team
NRADC Team