Entry Form For 2012 Combined Training and Derby Track

Raheen-Na-Gun Stud’s Combined Training and Derby Track Entry Form 2012
Date:
Horse	Rider	Event no.	Fee €	Not-Registered with Eventing Ireland or Registered with Eventing Ireland
Total enclosed: €
I am the owner, the authorised agent, or have been authorised by the owner to make this entry.  I certify that I have read and understand the Rules of Official Horse Trials and I am aware that Eventing is a dangerous sport. I understand that neither the Organising Committee of this Event nor Raheen-Na-Gun Stud, accept any liability for any accident, damage, injury to horses, owners riders, grooms, ground spectators or any other person or property whatsoever.   I understand that Raheen-Na-Gun Stud strongly advises me to have my own Personal Accident Insurance in place. Please tick box to confirm all of the above:  c SIGNED: DATE: PARENT/GUARDIAN SIGNATURE (if rider under 18) COMMUNICATIONS TO: Tel No: ADDRESS: Mobile No: Email: Please forward completed entry forms to: Entries, Raheen-Na-Gun Stud, Dunningstown Road, Kilkenny. Enclosed: Amount:    €  ………………………………………….……………..      EURO CASH OR CHEQUE INCOMPLETE OR UNSIGNED FORMS WILL NOT BE ACCEPTED