Derby Course #1 Open for Schooling

Schooling Date: June 24th and 25th

Our derby course is open for schooling! Schooling will include banks, ditch, water complex, and all courses that were used in the most recent derby competition!

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Name Name First Last
Address Address
Street Address City State / Province / Region Postal / Zip Code
Phone Phone - ### - ### ####
Email
Emergency Contact Emergency Contact First Last
Emergency Phone Number Emergency Phone Number - ### - ### ####
Horses name
Coggins

Attach Files

Please note. If you have competed or schooled this horse in 2024 your horses information is on file! If you are unsure, please just add to this entry!
Rabies Certificate

Attach Files
Time Time : HH MM AM/PM

This course will be open to all. Please just give us an approximate time you will be schooling.
Will you be riding with a trainer?

Will you be riding with a trainer? Yes No
Trainers Name Trainers Name First Last
Trainers Email
* Insured trainers are welcome to instruct on the property with a proof of liability insurance. This certificate must be included with the complete entry. Please reach out if you have any questions concerning this. foxrunfarmgeneseo@gmail.com
We do have several trainers already on file for 2024!

Attach Files
Riding Release
Riders Signature
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Adult Signature if rider is under 18.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Fee's

Fee's Derby Course #1 Schooling
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Derby Course #1 Open for Schooling

Derby Course #1 Open for Schooling

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Riding Release

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Derby Course #1 Open for Schooling

Derby Course #1 Open for Schooling

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Riding Release

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