Paradocs Farm (Indoor Arena)
31164 Zoar Road
Locust Grove, VA 22508

ENTRY FORMS DUE BY January 10, 2012! Ride times to be emailed or phoned by January 13th. Limited ride times, so please enter by closing date! Full refund if scratch before closing date. After closing date, entries will be refunded only if time slot can be filled from waiting list.

Please include copy of current Coggins test, unless already on file from previous show this year.

**NEW**Prix Caprilli tests (Involve jumping small jumps during the dressage tests!) Email for details.

Schooling will be permitted indoors before the show plus between tests if weather is inclement. Outdoor ring available all day.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

ENTRY FORM

Horse's name_____________________________ Rider's name______________________________________________Junior/ Adult (circle)

Address:_____________________________________________________________________________

Phone:_________________email:____________________________________________

TESTS: Introductory A_______________ Introductory B________________ Introductory C____________Training 1___________Training 2________________Training 3_____________

First Level, test 1 ___________Prix Caprilli Intro_________Prix Caprilli 1________

First test $20 = ________________

Additional tests_____@ $10=________________

Other (Quadrilles, Pas de Deux, Freestyle)___________( @ $30 per team-----Please use separate entry form for each horse/ rider)

Beginner Horse or Rider Walk Class (Medium, Extended, Free Walk) ***May walk alone, be led, or have escort in ring, @ $10 _______________

Walk Test D @ $10______________________________ (Call or e-mail for test) Pre-Prix Caprilli (test with ground poles) @ $10______________(Call or e-mail for test)

Limited stalls available @ $25_______________

TOTAL ENCLOSED = __________________ Make checks payable to "Paradocs Farm, Ltd." 31164 Zoar Road, Locust Grove, VA 22508

I hereby agree that I ( and /or my child/ward ) am participating voluntarily in the Competition FULLY AWARE that horse sports, competitions and ALL equine activities of any kind involve INHERENT DANGEROUS RISKS of serious injury or death , including, but not limited to 1) the propensity of an equine to behave in dangerous ways; 2) the inability to predict an equine's reaction to sound, movement, objects, persons or animals; 3) surface and subsurface conditions; and 4) the possibility of equipment breakage , and by participating I expressly assume all risks of injury, death of loss to my persons, animals or equipment, and agree to indemnify and hold harmless Paradocs Farm, owners, officials, employees, and any and all associated with the show from and against all claims, whether or not such claim resulted directly or indirectly from negligent acts or omissions of said owners, agents, employees, et. al. I have read, understood and agree to abide by this and all Paradocs Farm policies in order to participate in this event.

SIGNATURE:___________________________________________________________________)In the case of a MINOR, attending adult MUST accept full responsibility for compliance of policies, and parent must sign waiver.)

DIRECTIONS:

From Fredericksburg: Take Rte 3 West to Wildnerness, turn left on Rte 20 (at Sheetz Station) Go 5 miles, turn right on Rte 611 (at Exxon Station). Go 2.6 miles, Paradocs Farm is on the left. Take second entrance .

From Orange: Take Rte 20 North 18 miles to Locust Grove. Turn left on Rt 611 (at Exxon Station). Go 2.6 miles, Paradocs Farm is on the left. Take second entrance .

From Culpeper: Take Route 3 East ~ 15 miles to Wilderness. Turn right on Route 20 (at Sheetz Station) Go 5 miles, turn right on Rte 611 (at Exxon Station). Go 2.6 miles, Paradocs Farm is on the left. Take second entrance .

ENTRIES DUE BY January 10, 2012!

Questions? Please contact Joan M. Prasse, D.V.M. Phone (540) 854-0753