2003 Virginia Regional Rally Entry Form for D.C.s

Revised 2/14/2003

Only entries that are entirely completed, signed by the D.C., and submitted with a CLUB CHECK will be accepted.

See the instructions at the end of this sheet. Be sure to read these before entering data into this form.

Rally :

xxxxxxxx

Rally Date :

xxxxxxxx

Scramble with :

Pony Club :

xxxxxxxx

Chaperone (Remember to carry a set of EMRs) :

Name :

xxxxxxxx

Hotel :

xxxxxxxx

Hotel Phone :

xxxxxxxx

E-Mail Address :

xxxxxxxx

Home Phone :

xxxxxxxx

Cell Phone :

xxxxxxxx

Coach (Tetrathlon, Show Jumping, and Eventing only) :

Name :

xxxxxxxx

Contact person :

Name :

xxxxxxxx

Phone :

xxxxxxxx

E-Mail Address :

xxxxxxxx

Team Name :

xxxxxxxx

(--------------------Coggins Information--------------------)

Name of Mount

(-------------- Secretary’s use only --------------)

Rider Name

Phone Number

E-Mail Address

Rating

DOB (mm/dd/yyyy)

Pony Club Age

Gender

(as in Program)

Height

Card?

Division/Level

Qualify?

(Exactly as on Coggins)

Accession #

Date Draw

Pinny #

2EMRs

RRF

Coggins

Captain 1

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

#VALUE!

xxxxxxxx

Advisor

xxxxxxxx

#VALUE!

xxxxxxxx

** Rider #5 slot is for Games and Tetrathlon only **

Volunteers (Each team must provide 3 volunteers or entry will not be accepted)

Name:

Phone Number:

Mailing Address :

E-Mail Address :

xxxxxxxx

Enclose:

Current Coggins (with matching mount name) for each mount

Two EMR Forms Original Signatures Please for each Pony Clubber

One signed Rally Release Form for each Pony Clubber

Signed Coaches Forms (Tetrathlon, Show Jumping, and Eventing only)

Signed Chaperone Forms

Completed Written Tests for all competitors (Quiz only)

Club Check for all entries payable to: VRPC

As D.C. of

xxxxxxxx

Pony Club, I verify that the above Pony Clubbers are members in good standing of this Club,

the Virginia Region Pony Clubs, and the USPC. In my opinion they are safe to compete in this rally at the level indicated.

They are thereby eligible to participate in this rally.

D.C. Printed Name :

xxxxxxxx

D.C. Signature :

xxxxxxxx

Date :

xxxxxxxx

Supplementary Information

Entry Fee :

xxxxxxxx

Number of stalls :

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

xxxxxxxx

$0.00

Late Fee:

xxxxxxxx

Total Enclosed :

$0.00

Club check made out to VRPC

Dressage and D Dressage :

Rider Name

Lower Test

Higher Test (may be the same as the first)

Pas de Deux

Partner

Musical Ride

Quadrille Ride

Partners

Captain 1

xxxxxxxx

Tetrathlon :

Rider Name

Swim Time (m:s)

# Div's Jumping Down

Sharing a horse with

Sharing a pistol with

Captain 1

xxxxxxxx

Instructions

All places where "xxxxxxxx" appears are places that need to be filled in.

Several fields are "lists". When you click on the "xxxxxxxx"s, a triangle will appear to the right of the field. Click on the triangle to display a list of values to select from. The "lists" are :

Rally

Pony Club

Rating

Gender

Card

Division

Qualify

All of the secretary's fields (EMR, RRF, and Coggins) except Pinny

Dressage Rides (regular rides, Pas de Deux, Musical, and Quadrille)

Several fields are calculated from other fields, as follows:

When you fill in :

This field fill be automatically filled in :

DOB

Pony Club Age

Pinny Number of the captain (Secretary use only)

Pinney Numbers of the rest of the team

Fees

Fee sub-total and Total Enclosed

Rider Names

Dressage and D Dressage Rider Names in the Supplemental Section

Rider Names

Tetrathlon Rider Names in the Supplemental Section

Ensure DOB is entered as mm/dd/yyyy or m/d/yyyy as in 07/14/1994 or 7/14/1994

Division/Level Notes:

Click on the Division/Level list and scroll down to the appropriate discipline in parentheses, then select the correct division under the discipline

Quiz : Junior D (12 or less), Senior D (13 and over), Junior C/B (14 or less), Senior C/B (15 and over), B/H/H-A/A are two member teams of any age

Tetrathlon : Junior and Senior non-qualifying divisions have reduced swim and run distances