zzShow Registration 2023 THF

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 *

Please Choose One *

CDCTA Member Number *

Street/City/State/Zip *

Date of Birth *

Rider Email *

Trainer Name *

Rider Phone Number *

Trainer Email *

Emergency Contact Name *

Barn/Group Name (CDCTA Barn of the Year) *

Emergency Contact Phone *

Horse's Name *

Breed *

Color *

Horse's Gender: *

Height *

Horse's Year of Birth *

Horse's Owner *

Owner's E-mail *

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

Thoroughbred Incentive Program Participant? *

T.I.P. Card Upload *

Max file size: 20MB

Class One: *

Class Two: *

Class Three: *

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 October 15th, 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 *

Paying with: *

PayPal Check by mail

Click continue button below to submit your entry and proceed to payment information for Checks and PayPal

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