OLD DOMINION MORGAN HORSE ASSOCIATION LTD.
2012 FUTURITY ENTRY FORM
October 6, 2012 at 1:00 PM
Fair of Virginia, Doswell, VA
ENTRY FEE —$10 PER HORSE PER ENTRY
1. Weanling Colts _____ 2. Weanling
3. Yearling Colts & Geldings _____
4. Yearling Fillies _____
5. Two Yr Old Colts & Geldings _____ 6.
Two Yr Old Fillies _____
7. Three Yr Old Stallions & Geldings _____
Three Yr Old Mares _____
(If entries warrant we will split stallions
9. Grand Champion Stallion (first & second place horses from classes 1, 3, 5, and 7 are expected to show back in the championship class; no
10. Grand Champion Mare (first
& second place horses from classes 2, 4, 6, and 8 are expected to show back in the championship class; no entry fee)
A horse entering an ALUMNI class must have (A) been nominated as a two-year-old in 2008
(when the ODMHA Futurity was reinstated), maintained its eligibility in 2009, and be returning to show in its fourth year
of age, OR
(B) participated in the
ODMHA Futurity prior to 2005. There is no maximum age limit as long as the
horse maintained its eligibility when the ODMHA had a futurity program.
hand Alumni Stallions and Geldings horse age 4 thru 12_____
In hand Alumni Stallions and Geldings horse age 13 and up_____
In hand Alumni Mares horse age 4 thru 12_____
hand Alumni Mares horse age 13 and up_____
Driving (any style carriage) horse age 4 thru 12_____
Alumni Driving (any style carriage) horse age 13 and up_____
Alumni Under Saddle (any seat) horse age 4 thru12_____ (walk, trot/jog, canter/lope)
18. Alumni Under Saddle (any seat) horse age 13 and up_____
(walk, trot/jog, canter/lope)
There will not be a championship class for Alumni.
Stall Fee $25 ____ YES please reserve a stall for
use one entry form per horse, indicating your desired class with a checkmark in the blank above.
Checks payable for entry AND stall fee to ODMHA. Entries
must be received at the Show Secretary’s home (Temple Joyce, 16463 W Crescent Lane Montpelier, VA 23192) by 5 p.m. Tuesday
September 27, 2012 with a copy of a negative Coggins taken within twelve months of show
date. Release form MUST be signed and returned as well. No post entries, no day of show entries other than
for the Alumni classes.
HORSE _________________________________________________________Foal Date_________
Liability/release statement (must be included with entry form, appropriate fees, and negative Coggins)
Horse’s name: _______________________________________________________
Owned by: _________________________________________________________
statement: I agree that I choose to participate voluntarily in the ODMHA
2012 Futurity with my horse as a handler, agent, coach, trainer or as a parent or guardian of a junior. I
am fully aware and acknowledge that horse sports and the ODMHA 2012 Futurity involve inherent dangerous risks of accident,
loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering and death (“Harm”).
I agree to release the ODMHA and the State
Fair of Virginia from all claims for money damages or otherwise for any Harm to me or my horses and for any Harm caused
by me or my horses to others, even if the Harm resulted, directly or indirectly, from the negligence of the ODMHA or the State
Fair of Virginia. I agree to expressly assume all risks of Harm to me or my horses, including Harm resulting
from the negligence of the ODMHA or the State Fait of Virginia. I agree to indemnify (that is, to pay any
losses, damages, or costs incurred by) the ODMHA and State Fait of Virginia and to hold them harmless with respect
to claims for Harm to me or my horses, and for claims made by others for any Harm caused by me or my horses at the Futurity.
I have read the United States Equestrian Federation (USEF)Rules about protective equipment, including GR801 and EV113,
and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the USEF strongly
encourages me to do so while WARNING that no protective equipment can guard against all injuries. If I
am a parent or guardian of a junior exhibitor, I consent to the child’s participation and agree to assume all of the
obligations of this Release on the child’s behalf. I agree that the ODMHA and the State Fair
of Virginia as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers
and affiliated organizations. I agree that if I am injured at the Futurity, the medical personnel treating
my injuries may provide information on my injury and treatment to the ODMHA and the State Fair of Virginia on the
official USET accident/injury report form. I represent that I have the required training, coaching, and
abilities to safely compete in this Futurity.
BY SIGNING BELOW, I AGREE TO BE BOUND BY ALL APPLICABLE USET RULES AND ALL TERMS AND PROVISIONS IN THE PRIZE LIST AND
OF THIS ENTRY BLANK.
OWNER: print name _____________________________
Signature ____________________________________________________________ date_________
Name and signature is required for entry.