Trail Challenge Entry Form Babcock Hill Fun Show Payment must be received either by check or by PayPal before the day of event. If payment is not received you are are not entered in the event.Event date(Required) MM slash DD slash YYYY Name(Required) First Last Date of Birth(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Horse's Names(Required)Please Attach current (within 1 year) Rabies and CogginsAttach Rabies/CogginsAccepted file types: jpg, png, pdf, doc, dox, jpeg, Max. file size: 128 MB.I will be paying:(Required) Check PayPal Checks, credit cards and cash accepted at the event.Class List(Required) 1. Leadline Equitation 2. Leadline Pleasure 3. Walk/Trot Equitation 4. Walk/Trot Pleasure 5. Equitation 6. Pleasure 7. Walk/Trot Ground Poles Equitation 8. Walk/Trot Ground Poles Pleasure 9. Ground Poles Equitation 10. Ground Poles Pleasure 11. Walk/Trot Crossrails Equitation 12. Walk/Trot Crossrails Pleasure 13. Crossrails Equitation 14. Crossrails Pleasure Walk/Trot Division classes #s 3,4, 7, 8 Walk/Trot/Canter Division classes #s 5,6, 9,10 15. Leadline Trail 16 Walk/Trot Trail 17. Trail 18. Trot Arena Race 19. Arena Race 20. Trot Cloverleaf Barrels 21. Cloverleaf Barrels 22. Trot Pole Bending 23. Pole Bending 24. Trot Surprise Pattern 25. Surprise Pattern Walk/Trot Gymkhana Division class #s 18,20,22,24 Gymkhana Division class #s 19,21,23,25 26. Intro A 26. Intro 1 (western) 27. Intro B 27. Intro 2 (western) 28. Intro C 28. Intro 3 (western) 29. Intro 4 (western) 30. Training 1 30. Basic 1 (western) 31. Training 2 31. Basic 2 (western) 32. Training 3 32. Basic 3 (western) 33. Basic 4 (western) 34. First Level 1 34. First Level 1 (western) 35. First Level 2 35. First Level 2 (western) 36. First Level 3 36. First Level 3 (western) 37. First Level 4(western) LESSON HORSE USE (if applicable, for current students) $40 COACHING (Available for current students) $40 LEAD LINE HELPER $25 POST ENTRY FEE (if not Registered 1 week prior to show) $25 OFFICE FEE Total Class List(Required)Please check the event you plan on attending, total your fees and mail payments to: Dawn Bonin Horsemanship, 577 Babcock Hill Road, Coventry, CT 06238 1. Leadline Equitation $!5 2. Leadline Pleasure $!5 3. Walk/Trot Equitation $!5 4. Walk/Trot Pleasure $!5 5. Equitation $15 6. Pleasure $15 7. Walk/Trot Ground Poles Equitation $15 8. Walk/Trot Ground Poles Pleasure $15 9. Ground Poles Equitation $15 10. Ground Poles Pleasure $15 11. Walk/Trot Crossrails Equitation $15 12. Walk/Trot Crossrails Pleasure $15 13. Crossrails Equitation $15 14. Crossrails Pleasure: Walk/Trot Division classes #s 3,4, 7, 8 Walk/Trot/Canter Division classes #s 5,6, 9,10 15. Leadline Trail $50.00 16 Walk/Trot Trail $50.00 17. Trail $15 18. Trot Arena Race $15 19. Arena Race $15 20. Trot Cloverleaf Barrels $15 21. Cloverleaf Barrels $15 22. Trot Pole Bending $15 23. Pole Bending $15 24. Trot Surprise Pattern $15 25. Surprise Pattern $15 Walk/Trot Gymkhana Division class #s 18,20,22,24 $50.00 Gymkhana Division class #s 19,21,23,25 $50K 26. Intro A $25.00 26. Intro 1 (western) $25.00 27. Intro B $25.00 27. Intro 2 (western) $25.00 28. Intro C $25.00 28. Intro 3 (western) $25.00 29. Intro 4 (western) $25.00 30. Training 1 $25.00 30. Basic 1 (western) $25.00 31. Training 2 $25.00 31. Basic 2 (western) $25.00 32. Training 3 $25.00 32. Basic 3 (western) $25.00 33. Basic 4 (western) $25.00 34. First Level 1 $25.00 34. First Level 1 (western) $25.00 35. First Level 2 $25.00 35. First Level 2 (western) $25.00 36. First Level 3 $25.00 36. First Level 3 (western) $25.00 37. First Level 4(western) $25.00 LESSON HORSE USE (if applicable, for current students) $40 LEAD LINE HELPER $25 POST ENTRY FEE (if not Registered 1 week prior to show) $25 OFFICE FEE $15 If other please explain Permission to Photograph. I grant to Dawn Bonin/Babcock Hill, the right to take photographs of me and my family in connection with the above-identified program. I authorize Dawn Bonin/Babcock Hill, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Dawn Bonin/Babcock Hill may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.(Required)YesWaiver Signature. I hereby acknowledge and understand that horseback riding and the handling of horses and ponies are dangerous activities which can result in injury or death. I, the undersigned, from this date on, hereby release, indemnify, and hold harmless Babcock Hill Horses Naturally LLC, Dawn Bonin Horsemanship LLc and all owners and affiliations of property at this event, from any and all claims, actions, suits, and/or damages that may occur as a result of any injuries sustained while horseback riding, handling, or being near horses or ponies. This shall include all losses, damages, costs, and counsel fees that may occur as a result of injury, and related claims by any parties. I understand that inherent risks are involved in riding, handling, or being near horses and ponies. The inherent risks include but are not limited to the propensity of equines to behave in a way such as, running, bucking, biting, kicking, shying, stumbling, rearing, falling, or stepping on. Also the unpredictability of equines' reaction to such things as sounds, sudden movement and unfamiliar objects, persons, or other animals. By signing this agreement take full responsibility in the event of any injury. I have read this release, waiver and indemnity agreement, understand the risks involved and agree to assume them. I sign this agreement voluntarily and with full knowledge of its significance.*(Required)YesSignature(Required)Date(Required) MM slash DD slash YYYY I am(Required) Applicant Parent Payment Method*PayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Untitled First Choice Second Choice Third Choice