Vermilion Light Horse Show Entry Form
(Please complete one entry form per horse)
ENTRIES (WITH PAYMENT)
CLOSE JULY 17,2017**
OWNER INFORMATION:
Owner/Lessee:
Phone Number:
Address:
Province:
City/Town:
Postal Code:
Email Address:
Emergency Contact Name & Number:
JUNIOR EXHIBITOR: (JUNIOR EXHIBITORS MUST WEAR PROTECTIVE HEADGEAR WITH HARNESS IN ALL CLASSES)
Name:
Date of Birth (YY/MM/DD):
Age:
Height:
Age:
Parent/Legal
Guardian Signature:
HORSE INFORMATION:
Name of Horse:
Class # Fee Rider Name
Horse Name
Entry Fees:
Open Classes—$7.00 per class
Senior Performance—$7.00 per class
Junior Performance—$5.00 per class
Mail entry with fees to:
Light Horse Show
Box 3565
Vermilion, AB
T9X 2B5
**Cheques payable to:**
Vermilion Agricultural Society
** Entries received after the deadline will be double
the entry fee. Entry forms submitted that do not have
payment accompanying them (ie. faxed entries) will
not be official and will not hold RV or box stalls.
Class # Fee Rider Name
Total Entry Fees:
Horse Name
$
EXTRAS
Cost Quantity
Tie Stall:
$15
Box Stall:
$45
RV Hook Up:
$50
Gate admission will be charged
upon entering the fair grounds.
$10 per day or pre- purchase a 3
day pass for $20.
$20
TOTAL PAYMENT:
RV SIZE:
$
***Remember to include two separate cheques for Stall and Number Deposits.
Stall Deposit $20.00
Horse Number
Please see reverse
(Office Use)
Number Deposit $5.00
Note:

Box stalls are limited and are issued based on the date of receipt of entry form and payment by the
Vermilion Agricultural Society office. First registered will be the individuals first served.

Please include 2 separate cheques:
$5.00 number deposit
$20.00 stall cleaning deposit
Number deposit and stall cleaning deposit must be included with the entries. Stalls will not be secured
without payment. The deposits are refundable when the number is returned and the stall is cleaned.

WAIVER
I acknowledge that I have read and understood the “Rules and Regulations”, and make this entry in accordance
with them, and at my own risk. I understand that the rules of the Vermilion Light Horse Show parallel those of
Equine Canada, or as decided upon by the Light Horse Committee.
Liability: All exhibitors shall be under the control and direction of the Vermilion Agricultural Society, but solely at
the risk of said exhibitor. The Vermilion Agricultural Society will not be responsible for damage, injury, loss, or
theft of or to any exhibit, irrespective of the cause of such damage, injury loss, or theft. Each exhibitor will be
solely responsible for any loss, injury, or damage done to, administered by or arising from any animal or article
exhibited by him/her, for its description as given in the catalogue. This shall indemnify the Vermilion Agricultural
Society against all legal or other proceedings in regard thereto.
Signature of Rider:
Signature of Owner/Lessee:
Signature of Parent/Guardian:
(Junior exhibitors only)
Office Use
Date
Amount
Amount
Receipt
Late Entry
Fee
Prize
Money
Amount
Owing
Cheque
No.