Hunter and Equitation Registration Starting 8am Hunter and Equitation-` 7/23/2023 Show Release 7/23/23 Points for this show will count for Line It Up Year End Awards. Rider Name * Parent/Guardian if rider is under 18 Phone Number * Email * Address Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Emergency Contact Emergency Phone # Horse(s) Name (please indicate which horse with which division) * TIP number (or n/a) * Trainer/ Barn Name Leadline Leadline Whole Division Leadline – Walk Leadline – Walk /Trot Leadline – Off Lead Advanced Leadline Advanced Leadline – Whole Division – Advanced Leadline – Walk Advanced Leadline – Walk/Halt Advanced Leadline – Walk/Trot Long Side Walk, Trot, Individual Canter Division Walk, Trot, Individual Canter – Whole Division Walk, Trot, Individual Canter – Walk/trot Walk, Trot, Individual Canter – Walk/Trot/ Ind Canter Walk, Trot, Individual Canter – 4 ground poles Pre-Short Stirrup Division Pre-Short – Whole Division Pre-Short – Walk Pre Short – Walk/Trot Pre-Short – 2 Trot poles Walk Trot Division W/T – Whole Division W/T – Walk, Trot/Jog – Equitation W/T – Walk, Trot/Jog – Pleasure W/T – Walk Trot/Jog 4 cross rails (trotting allowed) or Pattern Short Stirrup Division Short – Whole Division Short – Walk /Trot Short – Walk/Trot /Canter Short – 4 crossrails Beginner Rider Division Beginner Rider – Whole Division Beginner Rider – Walk/Trot Beginner Rider – Walk/Trot/Canter Beginner Rider – Crossrails Crossrail Hunter Division Crossrail Hunter – Whole Division Crossrail Hunter – Over Fences Crossrail Hunter – Over Fences Crossrail Hunter – Under Saddle Baby Green Hunter Division Baby Green – Whole Division Baby Green – Walk, Trot Baby Green – Walk, Trot, Canter Baby Green – Over Fences Adult Rider Division Adult Rider – Whole Division Adult Rider – Walk, Trot/Jog Adult Rider – Walk, Trot/Jog, Canter/Lope Adult Rider – Over Fences or Pattern Lesson Horse Division Lesson – Whole Division Lesson – Walk, Trot/Jog Lesson – Walk, Trot/Jog, Canter/Lope Lesson – Over Fences or Pattern Pleasure Horse/Pony Division Pleasure – Whole Division Pleasure – Walk-,trot/Jog Pleasure – Walk, Trot/Jog, Canter/Lope Pleasure – Over Fences or Pattern Novice Equitation Division Novice Eq – Whole Division Novice Eq – Walk, Trot Novice Eq – Walk, Trot, Canter Novice Eq – Over Fences Modified Hunter Division Modified – Whole Division Modified – Over Fences Modified – Over Fences Modified – Under Saddle Open Equitation Division Open Eq – Whole Division Open Eq – Walk, Trot Open Eq – Walk, Trot, Canter Open Eq – Over Fences Thoroughbred Hunter Division Thoroughbred – Whole Division Thoroughbred – Over Fences Thoroughbred – Over Fences Thoroughbred – Under Saddle Hopeful Hunter Division Hopeful Hunter – Whole Division Hopeful Hunter – Over Fences Hopeful Hunter – Over Fences Hopeful Hunter – Under Saddle Line It Up Member? (choose only one) * I’m riding a Line It Up horse (for any class; lease fee+Farm Fee) I am not riding a Line It Up Horse at any time in show (Farm Fee Only) Release: I understand that horse sports may be hazardous and dangerous. I assume any and all risk of loss or injury to myself, my animals and equipment, other animals or persons, and agree to release from liability and to hold harmless Line it Up, LLC, all horse show personnel, and volunteers. WARNING: Under Pennsylvania law an equine professional and equine activity sponsor is not liable for an injury to or death of a participant in equine activities resulting from the inherent risks of equine activities. Inherent risks of equine activities includes: 1) The propensity of an equine to behave in a manner which may cause injury, harm or death to a person on or near it. 2)The unpredictability of an equine’s reaction to sounds, sudden movements, unfamiliar objects, individuals or other animals. 3)An equine’s reaction to certain natural hazards, such as surface and subsurface ground conditions. 4)A collision with other equines or objects. 5)An equine’s response to the participant’s manner of handling or controlling it or inability to handle or control it. Coggins Yes No Flu/Rino Yes No Competitor Signature(s) Signature of Competitor (18 and Over) / Signature of Guardian (under 18) * Clear Date Signed Payment * Payment (cash, check, venmo) (venmo link after submission) Total Total Paypal payment Submit
