Select Show Date. Closing date 2 days before show. Apple Tree Farm South Windsor, SC 2-Phase Entry Select Show Date. Closing date 2 days before show. □ January 12, 2017 □ January 21, 2017 □ January 25, 2017 □ February 2, 2017 □ February 16, 2017 □ February 23, 2017 □ March 2, 2017 □ March 16, 2017 □ March 23, 2017 SELECT COMPETITION LEVEL COMBINED TEST LEVELS $50 DRESSAGE ONLY $30 □ Starter – 2015 Intro Test B. Jump 12” □ 2015 Intro Test B □ Pre-Elementary– 2015 Intro Test B. Jump 18” □ BN Test A □ Elementary – 2014 BN Test A. Jump 2’ □ BN Test B □ Advanced Elementary– 2014 BN Test A. Jump 2’3” □ Novice Test A □ Beginner Novice– 2014 BN Test A. Jump 2’7” □ Novice Test B □ Novice – 2014 Novice Test A. Jump 2’11” □ Training Test A □ Training – 2014 Training Test A. Jump 3’3” □ Training Test B □ Preliminary - 2014 Preliminary Test A. Jump 3’7” □ Prelim. Test A □ Intermediate – 2014 Intermediate Test A. Jump 3’11” □ Prelim. Test B □ Intermediate A □ Intermediate B □ Other___________________ □ Extra Jump Round $10 □ Level: ___________________ □Extra Dressage Round $20 □ Unlimited jump rounds $30/same horse/rider combo Level: ___________________ Rider Name: _______________________________________ Horse Name: ________________________ Phone Number: (_____) _____-_______ E-mail: _____________________________ Address: __________________________________ City, State, Zip: __________________, ____, ________ □ Professional □ Non-Professional Trainer: __________________________TIP #_________________ Please send all entries, payment and coggins to: Apple Tree Farm South 1530 Oak Ridge Club Road Windsor, SC 29856 803-266-5870/603-345-0382 apltrefarm@aol.com www.appletreefarm.org Please make checks payable to: Apple Tree Farm Payment: Combined Test (one level) $50 ______ Jump Round Only $20 ______ Unlimited jump rounds/horse $30 ______ Dressage Only Test $30 ______ Extra Dressage Test $20 ______ TOTAL _________ I am aware that riding horses is an athletic event which poses potentially serious risks of injuries.  I understand that I may be injured as a results of my negligence, the negligence of others or through no fault of my own or anyone else due to the activity in which I am engaged.  I hereby hold harmless Apple Tree Farm, its owners and agents, the organizers and volunteers of this event for any injury or death I might sustain as a result of my participation in this event or by being on the grounds.  Signature of Rider and/or Parent (rider under 18) ____________________________________________ Date: _______________________________________