A negative Coggins 		2021 	MARYLAND PONY BREEDERS
       Annual Show		Copies of registration 	
	 Certificate 						papers and 	
dated since7/10/20 7/7/09/2015			July 10th-11th, 2021 	Equestrian Center of Harford County 	measurement cards 	
must be attached 					 must be attached 	
	for each pony 				Pre-entries must be postmarked by July 1st 2021			
	entered. 				Entry fees: Welsh Halter: $40, performance $20, Highland Halter $15, Open & Shetland classes $10     
                          Welsh Performance:	Pre Entry $20     Post entry $25
	          Open Classes 	Pre Entry $10     Post Entry $15
                           Shetland                       Pre Entry $15     Post Entry $25
                           Highland   	  	Pre Entry $15      Post Entry $25

         WPCSA non- member fee per Owner               $5
          WPCSA non- member measurement fee          $5  (Welsh Only)

																
Office Use 	Registered Name of 	Reg.# wpcsa 	Color 	Sex 	Hgt 	Age 	Breeding 	Classes 		Entry Fee 	
		Pony 	& usef											
					---------	-------						Sire 				
MC 	IEIA 	Owner 	Exhibitor/Rider 				Jr. Birth Date 	Dam 				
												Sire 				
MC 	IEIA 	Owner 	Exhibitor/Rider 				Jr. Birth Date 	Dam 				
												Sire 				
MC 	IEIA 	Owner 	Exhibitor/Rider 				Jr. Birth Date 	Dam 				
												Sire 				
MC 	IEIA 	!Owner 	Exhibitor/Rider 				Jr. Birth Date 	Dam 				
		PLEASE USE ONE ENTRY FORM PER OWNER 	Quantity: 		Total: 	
Mail entries to: Bonnie Six 						Stalls both shows $125
.  		This show only $75.				
	5125 Jolly Acres Road, Whitehall, MD 21161 										
										WPCSA fee (performance only) $5.00				
										@ $5.00 each: 					
		410-241-2958 						Electric hook-up fee @ $40 each (one time fee) 2show) 				
		Bonniesix17@gmail.com 						Truck License #: 				
												
Make checks payable to: Maryland Pony Breeders 	Non-WPCSA Owner fee $5 and $5 each pony measurement				
													
Payment in full must accompany this form. 	Signatures required on second page	Totals			
						
SIGNATURES REQUIRED IN Two (2) PLACES (AT X) BELOW 
ENTRIES NOT SIGNED WILL NOT BE ACCEPTED· CAREFULLY READ THIS AGREEMENT BEFORE SIGNING. 
For USEF class entries where want USEF points please sign additional form. 
            SIGNATURES BELOW INDICATE THAT I HAVE READ AND UNDERSTOOD THE ABOVE INFORMATION.
__Every entry at a WPCSA sanctioned show shall constitute an agreement and affirmation that all participants: 1) shall be subject to the rules of the WPCSA and the local competition; 2) every animal and exhibitor is eligible as entered; 3) agree to be bound by the rules of the WPCSA and the local competition and accept as final any decision of the WPCSA or competition on any questions arising under said rules and agree to hold the competition, the WPCSA, their Officials, Directors and Employees harmless for any action taken; 4) agree that they participate voluntarily in the competition fully aware that equine sports and the competition involve inherent dangerous risks and by participating they expressly assume all risks of injury, loss (including death), sickness or disease (including communicable disease) and agree to indemnify and hold the WPCSA, the competition and their Officials, Directors, Employees and Agents harmless from all claims including injury or loss during or in connection with the competition whether or not such injury or loss resulted, directly or indirectly, from negligent acts or omissions of said Officials, Directors, Employees and Agents of the WPCSA or the competition. I also agree to be responsible for any injury or damage caused by me, my horse, my employees or others under my direction and control at any Welsh event.

X_________________________________________                  __________________________________________________
                  Owner, Lessee Signature                            Rider, Driver , Handler Signature (if Jr. consent given below)

Print Name__________________________________________  Print Name_____________________________________

Address____________________________________________   Address_______________________________________

Phone______________________________________________  Phone_________________________________________

Email_______________________________________________  Email_________________________________________

Owner/Lessee WPCSA Number  _________________________ Rider, Driver, etc. WPCSA Number_____________

Junior/Minor Exhibitor consent: To be signed by Parent Guardian or Trainer:  I hereby consent to the entry of my child in this horse show and acknowledge that I have read this entry form and agree to the applicable conditions, waivers and consents and accept responsibility for the participation of said Junior (Minor).

____________________________________________________________________________
Parent, guardian, or trainer signature