ASSOCIATE HORSE SHOW APPLICATION
ASSOCIATE HORSE SHOW APPLICATION
BACK TO VHSA HOME PAGE (In order to print this application, you must click anywhere on the application before requesting printout) Office Use Only: Amt Pd: $_________ 2006-2007 Date Pd: _________ VHSA ASSOCIATE Check #: _________ COMPETITION APPLICATION Please fill this form out COMPLETELY!
Name of Competition: __________________________________ Location (City/State): ______________________
Show Date(s) Requested: __________________________________
Competition dues enclosed: $______ ($35 per show, $35 per day for consecutive multiple day shows. Must be
submitted 30 days prior to show date or add $100 late fee)
As of 04/01/07 all shows are required to provide the VHSA a Certificate of Insurance naming the VHSA as additional
insured for each horse show date. By signing here, Show Management agrees that the above insurance requirement
will be fulfilled:
_______________________________________ (Signature of Manager)
Prize List Enclosed? Yes ____ No ____(Must be submitted 30 days prior to show date for review or add $50 late fee)
Name of Judge: _______________________________________ VHSA # ________________
Competition Manager:__________________________________ VHSA # ________________
Mailing Address: ______________________________________ (Must be a VHSA Senior Member)
City/State/Zip: _______________________________________
Telephone: (_____) _________________________________ Fax: (_____) ________________________
E-mail Address: _________________________________ -or- Website address: _________________________
Show Secretary: _____________________________________
Mailing Address: _____________________________________ Telephone: (_____) ____________________
City/State/Zip: _______________________________________ E-mail Address:_______________________
Mailing Labels: 1st Set @ $10.00-Ea.set thereafter, $15.00 per set. Do you want a set of mailing labels? Yes__ No__
Date needed by: _________ Zip Code Order? Yes ____ No ____ (Will be sent alphabetical if not marked)
Please check which divisions and/or classes you intend to offer:
Hunter Divisions: Jumper Divisions: VHSA Assoc. Equitation Classes:
_____ Junior/Children's Hunter _____ Novice Jumper _____VHSA Assoc Child/Jr Eq.
_____ Adult Amateur Hunter _____ Low Jumper _____VHSA Assoc Adult Eq.
_____ Small/Medium Pony Hunter _____ Schooling Jumper _____VHSA Assoc Pony Eq.
_____ Large Pony Hunter _____ Modified Jumper
_____ Green Pony Hunter _____ Children/Adult Jumper VHSA MEDAL CLASSES:
_____ Green Hunter _____ Novice Ch/Ad Jumper (Exh.must be "Regular" Mbrs)
_____ Working Hunter VHSA Medals cannot be combined
_____ Hunter Pleasure Pony _____VHSA Children's Medal
_____ Adult Hunter Pleasure Horse _____VHSA Adult Medal
_____ Junior Hunter Pleasure Horse _____VHSA Pony Medal
_____ Short Stirrup Hunter(12 & Under)
Note: Application, fees, and show prize list are to be received in the VHSA office 30 days prior to competition date.
Show results must be postmarked no later than seven (7) days following the competition. If not postmarked in the
allotted time, a $100 fine will be imposed and possibility of future shows having their "VHSA Associate" recognition
canceled. Any Judge officiating at a VHSA Associate recognized show must be a current VHSA Senior Member
at least 21 years of age. Please refer to the VHSA Associate Program Guidelines for further requirement details.
VHSA Office Only: Tracking ____ Web ____ Packet(s) ____ Labels ____ Database
__________________________________________________________________________________________________
32 Ashby St., Suite 204 www.vhsa.com (540)349-0910
Warrenton, Virginia 20186 vhsa@verizon.net FAX (540)349-0094