Glass Ed Pine Lake September Dressage Show Online Entry Form

Online entry for the Glass Ed Pine Lake September Dressage show only! Please do not use this form for any other Glass-Ed shows.

Complete a separate entry form for each horse/rider pair. After completing the entry form, click on “Enter” at the bottom. You will be redirected to a PayPal checkout for payment. You will receive two confirmation emails: one for the entry submission, and one payment confirmation from PayPal. If you have any questions regarding the online entry form, please contact us!

Please note, a small amount is added to all online transactions to cover PayPal fees.

Pine Lake September Dressage Show entry

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HORSE INFORMATION

Horse Name:*

Photocopy of negative Coggins MUST be attached or entry will be rejected. Horse's name on Coggins must match name on entry. Click button to choose file: jpg, jpeg, png, gif, doc, docx, xls, xlsx*

RIDER INFORMATION

Rider Name:*

Memberships:*

Member of Glass-Ed $0

Member of MDC $10

Non-Member $10

Glass-Ed Member #:

Address:*

Street AddressCityStatePostal / Zip Code

Phone:*

Area Code

-

Phone Number

E-mail:*

Riders under 21 or turning 21 during this show year ride as a Junior/Young Rider. Riders over 22, or who will turn 22 during this show year compete as adults, either Amateur or Open.

Rider Status:*

Adult Amateur        

Jr/Young Rider        

Open

Birthdate if Jr/YR:

01020304050607080910111213141516171819202122232425262728293031

 / 

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

 / 

20162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901

day

month

year

HORSE OWNER (not required if rider is owner)

Horse Owner Name (if different than rider):

Owner Glass-Ed #:

Owner Address:

Street AddressCityStatePostal / Zip Code

Owner Phone:

Area Code

-

Phone Number

Owner E-mail:

TRAINER (optional)

Trainer Name:

Trainer Glass-Ed #:

Trainer Phone:

Area Code

-

Phone Number

Trainer E-mail:

CLASSES

A horse at Introductory Level may enter a maximum of six classes per day. Horses entered in any class at Training Level or above (including Basic Level western dressage or ANY class that includes canter) may enter a maximum of four classes per day.

Entry 1:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 -Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 - Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Entry 2:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 - Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 -Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Entry 3:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 - Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 -Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Entry 4:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 - Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 - Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability840 WDAA Level 2 or 3 Test of Choice702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Entry 5:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 -Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 - Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Entry 6:

Select class31 USDF Intro Test A - Jr/YR32 USDF Intro Test B - Jr/YR33 USDF Intro Test C - Jr/YR21 USDF Intro Test A - AA & Open22 USDF Intro Test B - AA & Open23 USDF Intro Test C - AA & Open91 Training Test 1 - Jr/YR92 Training Test 2 - Jr/YR93 Training Test 3 - Jr/YR81 Training Test 1 - AA82 Training Test 2 - AA 83 Training Test 3 - AA71 Training Test 1 - Open72 Training Test 2 - Open73 Training Test 3 - Open101 First Level Test 1 - Jr, AA & Open102 First Level Test 2 - Jr, AA & Open103 First Level Test 3 - Jr, AA & Open201 Second Level Test 1 - Open202 Second Level Test 2 - Open203 Second Level Test 3 - Open301 Third Level Test 1 - Open302 Third Level Test 2 - Open303 Third Level Test 3 - Open811 WDAA Intro Test 1 - Open812 WDAA Intro Test 2 - Open813 WDAA Intro Test 3 - Open814 WDAA Intro Test 4 - Open821 WDAA Basic Test 1 - Open822 WDAA Basic Test 2 - Open823 WDAA Basic Test 3 - Open824 WDAA Basic Test 4 - Open831 WDAA Level One Test 1 - Open832 WDAA Level One Test 2 - Open833 WDAA Level One Test 3 - Open834 WDAA Level One Test 4 - Open840 WDAA Level 2 or 3 Test of Choice840 WDAA Level 2 or 3 Test of Choice701 Dressage Suitability702 Dressage Equitation703 Walk/Trot Dressage Equitation706 Leadline Walk/Trot Eng or West 7 & Under600 Standard Musical Freestyle603 Freestyle Anything Goes604 Pas de Deux Anything Goes Musical (per rider)605 Quadrille Anything Goes Musical (per rider)501 Test of Choice - English Tests, Small Ring502 Test of Choice - English Tests, Large Ring

Specify Test(s) of Choice:

Musical Freestyle Level:

Pas de Deux Team Name:

Quadrille Team Name:

Leader for Leadline Entry:

I will be riding my western tests GAITED:

Yes- GAITED

STABLING AND CAMPING

Oak box stalls. Stabling is very limited; please phone (269) 664-4223 for availability before mailing entry. No arrivals prior to 6:00pm on previous day of showing.

Stabling:*

No stabling

Stall, day of show ($35)

Stall, preceding night and day of show ($45)

Stable with:

Camping:*

No camping

Camping, no hookup ($7)

Camping, with electrical hookup ($15)

Late Fee:

Late Fee $5

TOTAL

Total Entry Fees, Non Member Fees, Camping and Stabling:

ENTRY AGREEMENT

Every entry at this show shall constitute an agreement that the person making it (owner, lessee, trainer, manager, agent, coach, drive handler, rider, horse) shall be subject to the constitution and rules of any and all organizations sanctioning this show, and the rules of the show itself, and that every rider, handler, and or driver is eligible as entered and the owner, rider and any of his representatives are bound by the constitutions of any/ all organizations sanctioning the show, and the show itself, and agree to hold the show, the officials, directors, and employers of the show and/or any/all of the organizers or bodies sanctioning the show, and employees of any of these organizations and the owners of the show grounds harmless for any action taken. The constitution of application of these rules is governed by the laws of the State of Michigan. I, the undersigned, hereby enter the above horse at my own risk and I further agree that if damage is occasioned or loss occurred to the horse exhibited, to any vehicles, or to other article(s) which I may send with such horse, I will make no claim therefore against the management, the owners of the show grounds, the officials of any and all sanctioning organizations and any person involved herein. I also agree that as a condition of entry, GLASS-ED may use photographs of me and my horse taken during the course of the competition for the promotion of GLASS-ED. 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.*

I agree

Who to contact with entry questions?*

Rider        

Owner        

Trainer

Word Verification:

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