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Pony Club Jump Night
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capital Region 2017 Tetrathlon Rally Entry Form
For details on the rally including information on qualifying for Championships, tentative schedule and required forms,
please click here
. This online form replaces the entry form.
Indicates required field
Name of Pony Club or Center
Please specify if you are a member of Capital Region or if you are a member of another region.
Pony Club Age
Do you plan to qualify for Championships in 2018 in tet?
Name of Horse (must match coggins)
Please upload coggins for mount
Max file size: 20MB
8 and Under
10 and Under
Requested jumping height, if not jumping at your division level (penalty applies)
Poles/Cross Rails (8 and Under)
18" (10 and Under)
Are there any special considerations for this rider? If so, please specify.
So that competitors can swim in heats with swimmers of similar ability, please list a time from previous competition (if available, otherwise estimate) or write unknown. Please specify meters or yards.
Please indicate if you are sharing a mount
Please you are sharing a mount, let us know who you are sharing with. This helps us develop riding schedules.
Please indicate if you are sharing a gun:
I need to borrow one from SVPC
If you are sharing a gun, please give us details below.
Will you be using a loader during the shooting round?
If you are using a loader, please give us their name and let us know if they are also competing in tet rally.
We need parent volunteers in all phases. Please indicate the name and email for parent volunteer(s) for competitor and any limitations to ability to volunteer.
Name of coach for riding phase and his or her email address. You can also indicate if members will have coaches for other phases. The riding coach is required, other phases do not require a coach.
If you have any questions please feel free to contact me by phone (401) 714-4693 or by e-mail firstname.lastname@example.org or consult USPC Tetrathlon Rulebook or the USPC Horse Management Rulebook.
per competitor (postmarked by August 20), or
(postmarked after the 25
). For Capital Region members only, if siblings are competing the fee after the first child is
. Please make your check out to:
Capital Region Pony Club
Please refer to the enclosed check list to ensure that you have completed, signed and submitted all forms.
Jacquelyn Dickey (
) 14098 Pomquay Court, North Potomac, MD 20878
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