DEPARTMENT 14

GYMKHANA

New Insurance Requirements for Exhibiting

Show Day: Saturday, August 31, 2019 starting at 11 AM
All horses and/or ponies must have proof of current rabies/immunizations

HORSE SHOW COMMITTEE

Judge (4-HShow)	TBD
Manager	Douglas Curtis, Concord, NH
4-H & Gymkhana Show Ringmaster	Steven Ducharme, Manchester, NH
Steward	Cindy Dougherty, Elkins, NH
Time keeper(Gymkhana)	Judy Forsyth, Center Barnstead, NH
Announcer	Suzanne Arthur,Chester,NH
Veterinarian On-Call	Blackwater Veterinarian Services
Gateman	Donald Dunlap, Chichester, NH
Farrier	Brian Loszewski, Candia, NH
Horse Show Secretary	Jennifer Dusavitch, Concord, NH

PLEASE NOTE

Use Yellow Gate for ALL Horse Shows.
Due to limited parking in the horse show area, priority is given to vehicles towing horse trailers and/or wagons.

GYMKHANA DIVISION

Gymkhana Entry fees are $15.00 per horse/pony and $5.00 for Walk Trot/Jog. High Cash Entry fees are $25.00 per class.
Pre-entries are preferred ONLINE by Wednesday 28, 2019, however entries day of the show will be accepted.
Six ribbons will be awarded in all classes. All decisions of the officials are final.
Patterns will be posted the day of the show.
Prize money will be awarded in the Show Ring. Management will not be responsible for prize money after award has been made.
Walk Trot Division – 12 years and under (not eligible to enter any class where canter/lope is permitted)
Junior Division – 17 years and under
Senior Division – 18 years and Over

RULES AND REGULATIONS

We abide by NHH&TA Rules.
Proper footwear (boots with a 1 inch heel) is mandatory. Running shoes/sneakers are not permitted, juniors/walk trot must wear a helmet and appropriate attire is mandatory.
Unsportsmanlike behavior or cruelty to animals will not be tolerated. You will be expelled from Fairgrounds without a refund. Any horse/rider/handler being unruly and/or out of control will be asked to leave Fairgrounds.
Show Management and/or judges decisions are final.
The horse must enter the ring unassisted. The horse must start from inside the ring and the gate must be closed before the horse starts. The gate must remain closed and the horse to come to a halt inside the ring before the gate is opened again. A rider may lead his/her horse from the ring.
Classes must be paid in full or leave blank check at secretary’s booth before entering the class.
No Refunds.
All warm up must be done in designated area.

Entry Form

OWNER NAME*
First Last
ADDRESS*
Street Address City State
ZIP Code*
DATE OF BIRTH*
Date Format: MM slash DD slash YYYY
E-MAIL ADDRESS*
TELEPHONE*
CLASS A - KEYHOLE RACE -1. Keyhole Race - Jr. -2. Keyhole Race - Sr. -3. Keyhole Race - Wt. CLASS B - FLAG RACE -4. Flag Race - Jr. -5. Flag Race - Sr. -6. Flag Race - Wt. CLASS C - POLE BENDING -7. Pole Bending - Jr. -8. Pole Bending - Sr. -9. Pole Bending - Wt. CLASS D - BARREL RACE -10. Barrel Race - Jr. -11. Barrel Race - Sr. -12. Barrel Race - Wt. CLASS E - RELAY RACE -13. Relay Race - Open CLASS F - QUADRANGLE STAKE RACE -14. Quadrangle Stake Race - Jr. -15. Quadrangle Stake Race - Sr. CLASS G - CASH POLE BENDING -16. Open High Cash Pole Bending CLASS H - CASH BARREL RACE -17. Open High Cash Barrel Race

ENTRY FORM*

Add a new line by clicking the PLUS icon and delete a line by clicking the MINUS icon.

CLASS	LOT	NAME OF HORSE	EXHIBITOR	AGE OF RIDER	OWNER

Every entry at the Recognized Show shall constitute an agreement that the person making it, owner, lessee, trainer, manager, Agent, coach, driver, rider and the horse shall be subject to the constitution and rules of the State of New Hampshire 4-H and the local rules of the show. It shall further constitute that every horse, rider and/or driver is eligible as entered and that the owner and any of his representatives are bound by the constitution and rules of the 4-H, and the show, accept as final the decision of the Hearing Committee on any question arising under said rules and agree to hold the show, their officials, directors and employees harmless for any action. I entered the above listed horses at my own risk and I agree to make no claims against the Hopkinton State Fair Horse Show if any damage, injury or loss be incurred. I agree to pay the sum of $100.00 as and for liquidation damages if animals, which I exhibited, are suffering from any contagious or infectious disease.
PREMIUMS
NEW… Premiums will be paid by check within 30 days following the fair.
If premiums exceed $599.00 a W-9 form must be completed prior to receiving premium.
PERMISSION AND APPROVAL
I have submitted all required documents and approvals to my 4-H Office. This document also states that I have received parental permission medical and granted, liability waver, which means that you will not hold the HSF responsible from any claim connected to the fair. In case of a serious illness or injury the parent who signs this form will be notified, but if impossible to contact, you give permission for emergency treatment or surgery, as recommended by the attending physician

I hereby enter the following 4H Livestock in competition for the prizes offered by the Hopkinton State Fair as printed and subject to the Rules and Regulations in the 2018 Hopkinton State Fair Exhibitor Handbook.

*I have read the health regulations
Owner
Name
Signature*
Date
Date Format: MM slash DD slash YYYY
Parent/Guardian
Parent Signature if exhibitor is under 18
Name
Signature
Date
Date Format: MM slash DD slash YYYY
GYMKHANA ENTRY FEE
Price: $0.00
ENTRY FEE
$0.00
Credit Card*
American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

CLASS A – KEYHOLE RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
1.	KEYHOLE RACE – JR.	$50	$25	$15	$10
2.	KEYHOLE RACE – SR.	$50	$25	$15	$10
3.	KEYHOLE RACE – WT.	Trophy	***	***	***

CLASS B – FLAG RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
4.	FLAG RACE – JR.	$50	$25	$15	$10
5.	FLAG RACE – SR.	$50	$25	$15	$10
6.	FLAG RACE – WT.	Trophy	***	***	***

CLASS C – POLE BENDING

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
7.	POLE BENDING – JR.	$50	$25	$15	$10
8.	POLE BENDING – SR.	$50	$25	$15	$10
9.	POLE BENDING – WT.	Trophy	***	***	***

CLASS D – BARREL RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
10.	BARREL RACE – JR.	$50	$25	$15	$10
11.	BARREL RACE – SR.	$50	$25	$15	$10
12.	BARREL RACE – WT.	Trophy	***	***	***

CLASS E – RELAY RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
13.	Relay Race – Open (Double entry fee, double prize money)	$50	$25	$15	$10

CLASS F – QUADRANGLE STAKE RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
14.	QUADRANGLE STAKE RACE – JR.	$50	$25	$15	$10
15.	QUADRANGLE STAKE RACE – SR.	$50	$25	$15	$10

CLASS G – CASH POLE BENDING

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
16.	OPEN HIGH CASH POLE BENDING (Entry Fee $25) Must enter and show in lot 7 or 8 in order to qualify	$250	$150	$100	$50

CLASS H – CASH BARREL RACE

LOT NO.	DESCRIPTION	1ST	2ND	3RD	4TH
17.	OPEN HIGH CASH BARREL RACE (Entry Fee $25) Must enter and show in lot 10 or 11 in order to qualify	$250	$150	$100	$50