KISS Performance Challenge Entry Form

Show Hall opens at 8 AM - Classes Begin at 9 AM
Please register no later than one week in advance to avoid late fees!!!!
Mail Entry with your Check or Money Order payable to Region 2 Champ Show to: Victoria Zanutto, 420 Elmhurst Street, Hayward CA 94544-1128.

Show #3 - October 1, 2010
Location: Lions Club, 12415 Murphy Avenue, San Martin
Show hostess: Victoria Zanutto, email vaz@comcast.net
Judge: TBA

Name:____________________________________________________

If proxy, name of horse owner you are showing for: _______________________________

Address:___________________________________________________

City, State, Zip:______________________________________________

Phone:_____________________________________________________

email:______________________________________________________

Entry Fee $40.00
Late Entry Fees $5

Please bring your own lunch; show hall is somewhat remote. Refrigerator space is available.
Proxy Entry - 10 horses maximum (no table provided) $25.00

CLASS sponsor (specify Class and division: SC/DC/AR or OF) $2.00
SECTION Sponsor (specify Other/Western/English) $5.00

Total Amount Due:

Sponsoring the following: (class name) _______________________________________

(division name) _____________________________________

- A fee of 25.00 will be charged for any bounced checks.
- Entries received with incorrect balance or balance due will be held until fees are paid in full.
- Entries are NOT COMPLETE until a signed release is on file with the Showholder!

A signed release from each entrant (or parent or guardian if you are under 18) is required, so follow up all entries with a printed copy, please! You may also bring your signed release with you and submit it at registration, but you will NOT BE ALLOWED TO SHOW WITHOUT THE SIGNED RELEASE ON FILE.

I hereby release the Lions Club of San Martin, the event coordinator, judge and helpers for the K.I.S.S. Performance Challenge of any liability for any personal injury, property damage or loss that may occur during the course of this one-day event. I further understand that all judges' decisions are final, and I agree not to hold any judge or member of the event staff liable for any decision or judgment that is made in the course of the event. I have read and understood the rules of K.I.S.S. and agree to abide by these rules. I understand that if these rules are violated, I may be asked to leave the class or event at any time with no refund of fees.

Signature:__________________________________________ Date: ________________

Parent/Guardian:____________________________________ Date: ________________