FEI ENTRY FORM - Arabian Nights

Rider Number:

(management use)

FEI ENTRY FORM - Oreana CEI***/** Arabian Nights

Complete this form and mail with your entry or final payment. Read and sign the US Equestrian Federation release of liability on the back!! PLEASE PRINT ALL INFORMATION.

Rider Name:________________________________ Rider US Equestrian Fed # ___________________________

(Enclose copy of membership card).

If non-US rider, give nationality:________________(non-US participant must have letter of permission sent to USEF and to management from your National Federation. All other nations are welcome, but please request that invitation be sent by USEF to your NF.

Horse Name:____________________________ Horse USEF #:______________(required for US horses)

Horse FEI Passport #:__________OR National Passport #:__________

Horse country of birth:________ Horse age:___ Horse gender:____

Horse Owner, if not rider above:_____________________________________________________

Owner Address:__________________________________________________________________

(Owner must also sign release/waiver on reverse side)

For CEI***/** rides , FEI or National passport is required. For CEI*** (100 mile) entries Senior International High Performance Due of $200/year, or $50 each for maximum of two events per year (exception for Endurance) must also be paid for CEI***(100 mile in one day). Junior USEF Members pay an annual fee of $100. Life Members are exempt from payment of IHP Due. This fee may be paid in advance to USEF or at the ride by check or credit card (NO CASH). Only the rider pays the IHP Due for competitions on the North American continent (owner and rider pay if outside NA).

All riders or horse owners please complete the following:
*** New Influenza Requirement, Please Read This

Equine influenza vaccinations: Two initial shots:__________ and __________(not less than 21 or

more than 92 days apart). Six Month booster dates:__________________________________

Coggins date:_____________Please attach copy.

Below this line, for management use only:

Passport # ________________ or Coggins Report_______ collected on May __, 2004, and

returned to owner on May __, 2004. Initials of official:___________.

Results of first examination: Temperature:_________ Pulse:___________ Metabolics:______________

Clinical signs of illness, if any:________________________________________________________

Allowed into stabling area:________ or Dismissed from competition:_____________

Date:_____________ Examining Veterinarian:___________________________________________

U.S. EQUESTRIAN MEMBERSHIP STATEMENT

LIFE, SENIOR, ACTIVE, AND JUNIOR ACTIVE MEMBERS SHALL BE ELIGIBLE TO PARTICIPATE IN ALL CLASSES AT REGULAR MEMBER COMPETITIONS, EVENTING COMPETITIONS AT THE PRELIMINARY LEVEL OR ABOVE AND COMBINED DRIVING COMPETITIONS AT THE ADVANCED LEVEL, DRESSAGE AND VAULTING COMPETITIONS AND ENDURANCE RIDES PROVIDED THE RESPECTIVE BREED/DISCIPLINE DUES OR BREED/DISCIPLINE CATEGORY FEE HAS BEEN PAID. A NON-MEMBER MAY PARTICIPATE AS A HANDLER, RIDER, DRIVER, OWNER, LESSEE, AGENT, COACH OR TRAINER AT REGULAR COMPETITIONS, EVENTING COMPETITIONS, DRESSAGE COMPETITIONS AND COMBINED DRIVING COMPETITIONS UPON PAYMENT OF A $20, NON-MEMBER REGISTRATION FEE AND A $5 BREED/DISCIPLINE CATEGORY FEE FOR EACH BREED/DISCIPLINE, PARTICIPANTS IN THE FOLLOWING CLASSES ARE EXEMPTED FROM THE REQUIREMENTS OF THIS RULE: 1) LEADLINE; 2/ EXHIBITIONS; 3) GAMES AND RACES; 4) CLASSES FOR 4-H MEMBERS; 5) WALK TROT AND ACADEMY CLASSES (Academy classes are classes limited to horses used regularly in a lesson program); 6) USDF INTRODUCTORY LEVEL TESTS, PAS DE DEUX AND QUADRILLE CLASSES. ALSO EXEMPTED FROM THIS REQUIREMENT ARE RESIDENTS OF OTHER NATIONS WHO ARE MEMBERS OF GOOD STANDING OF THEIR NATIONAL FEDERATION, 7) USEA BEGINNER NOVICE DIVISION, 8) ASSISTANT HANDLERS IN DRESSAGE SPORT HORSE BREEDING CLASSES, AND 9) CITIZENS OF OTHER NATIONS WHO ARE MEMBERS IN GOOD STANDING OF THEIR NATIONAL FEDERATION AND, IN THE CASE OF RIDERS, DRIVERS OR VAULTERS COMPETING IN DISCIPLINES RECOGNIZED BY THE FEI, IN POASESSION OF A FOREIGN COMPETITOR'S LICENSE TO COMPETE IN NATIONAL COMPETITIONS, WHICH HAS BEEN ISSUED BY THE FEDERATION.

U. S. Equestrian Entry Agreement

By entering a US Equestrian Federation-recognized Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the lBylaws and Rules of U .S. Equestrian ("the Federation") and the local rules of the competition. I agree to be bound by the Bylaws and Rules of the Federation and of the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition, the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the Rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the competition may use or assign photographs, videos, audios, cablecasts, or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. The construction and application of Federation Rules are governed by the laws of the State of New York, and any action instituted against the Federation must be filed in New York State.

U. S. Equestrian Release, Assumption of Risk, Waiver and Indemnification

This document waives important legal rights. Read it carefully before signing.

I AGREE in consideration for my participation in this Competition, Oreana CEI***/** Arabian Nights, to the following:

I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death ("Harm").

I AGREE to release the Federation and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted, directly or indirectly, from the negligence of the Federation or the Competition.

I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation and the Competition.

I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation and the Competition and to hold them harmless with respect to claims for Harm to me or my horse, and for claims made by others for any Harm caused by me or my horse at the Competition.

I have read the Federation Rules about protective equipment, including Articles 318 and 1713, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation 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 all of the above provisions and AGREE to assume all of the obligations of this Release on the child's behalf.

I AGREE that "the Federation" and "Competition" as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations.

I represent that I have the requisite training, coaching and abilities to safely compete in this competition.

BY SIGNING BELOW, I further AGREE to be bound by all applicable Federation Rules and all terms and provisions of this entry blank.

Rider/Driver/Handler/ Vaulter/Longeur Owner/Agent Trainer Coach (if applicable)

(mandatory) (mandatory) (mandatory)

Signature:_________________________ Signature:___________________ Signature:__________________ Signature:________

Print Name:________________________ Print Name:__________________ Print Name:_________________ Print Name:_______

Parent/Guardian Signature: (Required if rider, driver, handler, vaulter, longeur is a minor):______________________________________

Parent/Guardian Name:____________________________________ Emergency Contact Phone No:_____________________________

Is Rider/Driver/Vaulter a U. S. Citizen?: ______Yes _________No