2013-2014 Application
to Host an IEA Horse Show
For office use only
Date rcd. ____________
HS ID # ____________
Mail to: IEA 414 Main St. Suite C Melrose, MA 02176
____________________________________________________________________
(Primary Host- must submit Event Insurance Request Form)
_________________________________________________
(1st Co-Host)
_____________
(Zone/Region)
_____________________
(Zone Approved Show Date)
______________________________________________________
(2nd Co-Host)
Proposed Show Grounds:______________________________________________________________________________________
Contact Information :*** Show Manager will be listed on website as primary contact unless otherwise noted ***
Show Secretary:
Primary Host applications MUST
include the attached:
Show Manager:
Name__________________________ Name____________________________
Address_________________________ Address__________________________
IEA EVENT INSURANCE REQUEST
FORM
_______________________________ _________________________________
and appropriate payment of fee
Phone #_________________________ Phone #__________________________
$145.57 per competition day
Email _________________________
Email____________________________ Check_made payable to “IEA”
Please see Rules 4106 and 5300 for complete information regarding show entries.
Entry Restrictions:(circle one) Zone only: Y / N
.Competition
Region only: Y / N
Classification: (Please check all divisions offered)
___ Upper School Hunt Seat Competition
Required Classes:
Class 1. Varsity Open Eq o/f 2’6”
Class 2. Varsity Int. Eq o/f 2’
Class 3. JV Nov. Eq o/f x-rails
Class 6. Varsity Open Eq on the Flat
Class 7. Varsity Int. Eq on the Flat
Class 8. JV Nov. Eq on the Flat
Class 9. JV Beg. Eq on the Flat
___ Middle School Hunt Seat Competition
___ Upper School Western Competition
Required Classes:
Class 1. Varsity Open Horsemanship
Class 2. Varsity Int. Horsemanship
Class 3. JV Nov Horsemanship
Class 4. JV Beg. Horsemanship
Class 8. Varsity Open Reining
Class 9. Varsity Int. Reining
___ Middle School Western Competition
Required Classes:
Class 4. Future Int. Eq o/f 2’
Class 5. Future Nov. o/f x-rails
Class 10. Future Int. Eq on the Flat
Class 11. Future Nov. Eq on the Flat
Class 12. Future Beg Eq on the Flat
Required Classes:
Class 5. Future Int. Horsemanship
Class 6. Future Nov. Horsemanship
Class 7. Future Beg Horsemanship
Class 10. Future Int. Reining
_____ Additional Hunt Seat Classes Offered
(optional):
_____ Additional Western Classes Offered
(optional):
___ Varsity Open Championship Class
___ Class 9x. JV Beg Eq w/t
___ Class 12x. Future Beginner w/t
___ Class 4x. JV Beginner Horsemanship
walk/jog
____ Class 7x. Future Beginner
Horsemanship walk/jog
Show applications will not be complete
and will not be processed without the
included Insurance Request Form and
payment.
___ Upper School Saddle Seat Competition
Required Classes:
Class 1. Varsity Open Equitation
Class 2. Varsity Intermediate Equitation
Class 3. JV Novice Equitation
Class 4. JV Beginner Equitation-W/T
Class 8. Varsity Open Workout
Class 9. Varsity Intermediate Workout
Class 10. JV Novice Workout
___Middle School Saddle Seat Competition
Required Classes:
Class 5. Future Intermediate Equitation
Class 6. Future Novice Equitation
Class 7. Future Beginner Equitation
Class 11. Future Intermediate Workout
Class 12. Future Novice Workout
By signing below, the management agrees to abide by all IEA rules and policies, and acknowledges liability for subsequent fines if
these rules are not followed. In addition, the management certifies that the requested show date has been confirmed by the Zone
Chairperson.
Signature of Show Manager _______________________________________
Date _______201__
Event #:
________________
[provided by IEA]
IEA EVENT
INSURANCE REQUEST FORM
Date [s]of Event: ___________________________
IEA Approved
Zone: _______________
[Competition Dates only]
Submitted by: _________________________________________
Email Address: ________________________________________
[Please print clearly as Certificates will be emailed to this address]
Primary Hosting Team: ______________________________________________
Name of Additional Insured/Mailing
Address
Their Interest
[Landowner/Facility/Horse Provider/Co
Hosting Team]- Please indicate all that apply
Name:
Address:
City, Zip:
Name:
Address:
City, Zip:
Name:
Address:
City, Zip:
Name:
Address:
City, Zip:
Name:
Address:
City, Zip:
•
Insurance provided by Equisure Inc. and will include 3 Setup/take down days
automatically.
Premium Due: $145.57 per day x # Competition Dates ________= $___________
*Made payable to IEA to: 414 Main St., Suite C Melrose, MA 02176
Equisure Inc. 13790 E. Rice Pl. Ste. 100 Aurora, CO 80015 * 800-752-2472 * Fax 303-614-6967
Edition: 5/2013