VIRGINIA REGION PONY CLUBS SHOW JUMPING COMPETITION AFFIDAVIT(To be completed and presented for H2, H3, H4 Level candidates.) Name _____________________________  Horse _______________________ Level of jumper competition: _____________________________________ Name of competition___________________________  Location: _________________Date: ________________________Please provide information on each round ridden at the appropriate level. 1. Level/Height: _____________________         Penalties, if any: ___________________ 2. Level/Height: _____________________         Penalties, if any: ___________________ 3. Level/Height: _____________________         Penalties, if any: ___________________ 4. Level/Height: _____________________         Penalties, if any: ___________________ The above-named rider/horse combination has completed the above-mentioned competition with the penalties recorded above and without elimination. Signature ___________________________, or Signature _______________________          (Show Secretary)                                                  (Chief Judge)          Print name: _____________________ Print name: ________________________ The candidate for riding in H2 and above at the Regional Show Jumping Rally is responsible for providing this documentation to his/her DC before rally entries are due.