RMWF 2023 – Hackney Entry Form

Use the form below to enter the Barrel Racing competition at the 2023 Royal Manitoba Winter Fair.

NOTE: It is the responsibility of the competitor(s) to read and understand the Prize Book. You must also sign the Waiver of Claim per Rider at the end of the form, agree to the Vaccination requirements, and submit payment for all applicable fees. We use Square to process credit card payments. Your credit card details are NOT stored on our website.

Participants are required to carry in-force third-party liability insurance in the amount of no less than $2,000,000
which defends against lawsuits and/or settlements for bodily injury or property damage arising out of the
ownership, leasing or use of horses in the Royal Manitoba Winter Fair. This policy must have a policy territory
which includes Canada and be written by a reputable insurer who is satisfactory to the Provincial Exhibition of
Manitoba. Proof of such insurance is required to be submitted to the Provincial Exhibition of Manitoba with application. Email proof to info@provincialex.com or entries@provincialex.com.

All submissions will be processed upon receiving of payment.

IMPORTANT: Ensure that all REQUIRED fields are completed. If you submit the form with missing/incomplete information, the page will reload and will indicate any errors (shown in red). To resubmit the form you will need to re-enter your credit card information.

Submission Deadline: February 15, 2023

Royal Manitoba Winter Fair

RMWF - Hackney Horse Entry Form

Name(s) of Horse(s)/Pony(s)(Required)

Farm Name(Required)

Owner Name(Required)

First Last

Address (Owner)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email (Owner)(Required)

Phone (Owner)(Required)

Name of Driver

First Last

Address (Driver)(Required)

Same as Owner

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Is the Driver a Junior

Yes

Name (Junior Driver)(Required)

First Last

Birth Date of Junior Driver(Required)

Signature of Parent/Guardian(Required)

Entries

Class A1-1 Hackney/Modern Shetland/American Show Pony Pleasure Driving (Open)

25.00

N/A

Entry Fee

Name of Driver for Class A1-1(Required)

Class A1-2: Hackney/Modern Shetland/American Show Pony Pleasure Driving (Non-pro)

$25.00 Fee

N/A

Entry Fee

Name of Driver Class A1-2(Required)

Class A1-3: Hackney/Shetland/Show Pony Pleasure Driving Championship (Open)

$35.00 Fee

N/A

Entry Fee

Name of Driver Class #A1-3(Required)

Class A1-4: Hackney/Shetland/Show Pony Pleasure Driving Championship (Non- pro)

$50.00 Fee

N/A

Entry Fee

Name of Driver Class #A1-4(Required)

Class B2-1:Single Roadster Pony (Open)

$25.00 Fee

N/A

Entry Fee

Name of Driver Class B2-1(Required)

Class B2-2:Single Roadster Pony (Non-pro)

$25.00 Fee

N/A

Entry Fee

Name of Driver B2-2(Required)

Class B2-3:Single Roadster Pony (Open) Championship

$35.00 Fee

N/A

Entry Fee

Name of Driver Class B2-3(Required)

Class B2-4: Single Roadster Pony (Non-pro) Championship

$50.00 Fee

N/A

Entry Fee

Name of Driver Class B2-4(Required)

Class C3-1: Single Harness Pony (Open)

$25.00 Fee

N/A

Entry Fee

Name of Driver Class C3-1(Required)

Class C3-2: Single Harness Pony (Non-pro)

$25.00 Fee

N/A

Entry Fee

Name of Driver Class C3-2(Required)

Class C3-3: Single Harness Pony (Non-pro) Championship

$35.00 Fee

N/A

Entry Fee

Name of Driver Class C3-3(Required)

Class C3-4: Single Harness Pony (Open) Championship

$50.00 Fee

N/A

Entry Fee

Name of Driver C3-4(Required)

Class #300: Children's Costume Class

$15.00 Fee

N/A

Entry Fee

Name of Driver Class #300(Required)

Participants are required to carry in-force third-party liability insurance in the amount of no less than $2,000,000 which defends against lawsuits and/or settlements for bodily injury or property damage arising out of the ownership, leasing or use of horses in the Royal Manitoba Winter Fair. This policy must have a policy territory which includes Canada and be written by a reputable insurer who is satisfactory to the Provincial Exhibition of Manitoba. Proof of such insurance is required to be submitted to the Provincial Exhibition of Manitoba with application.

I have read and understood the RMWF Hackney Horse Prize Book. I hereby certify that every horse and driver are eligible as entered and agree for myself and my representatives to be bound by the Rules & Regulations as well as the code of conduct of the Provincial Exhibition of Manitoba and the Royal Manitoba Winter Fair.

Signature of Exhibitor(Required)

Signature of Parent/Guardian (if junior)(Required)

Pay Prize Money To:

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Admin Fee (Per Horse) (Required)

Price: $ 10.00 CAD

Environmental Fee(Per Horse) (Required)

Price: $ 15.00 CAD

Emt Fee(Per Driver) (Required)

Price: $ 15.00 CAD

Box Stall (Required)

Price: $ 125.00 CAD

Tack Box Stall (Required)

Price: $ 125.00 CAD

%5 GST(Required)

Price: $ 0.00 CAD

Additional Passes

Price: $ 69.00 CAD

Payment Method(Required)

Credit Card

Cheque

All submissions will be processed upon receiving of payment

PLEASE MAKE CHEQUES PAYABLE TO: Provincial Exhibition of Manitoba

Please mail cheque to: 1200 -13th St. Unit A-1 Brandon, MB, R7A 4S8

Total

Credit Card(Required)

Cardholder Name

Card Details

Driver Waiver

Name

First Last

Address(Required)

Same as Driver

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Home

Phone Cell

Phone Business

In consideration of the undersigned being permitted to participate in any of the events sanctioned or sponsored by the Provincial Exhibition of Manitoba the undersigned shall save harmless and keep indemnified the Royal Manitoba Winter Fair, Provincial Exhibition of Manitoba, Equine Canada, it's officers, agents, officials, organisers and representatives from against all claims, Canada, it's officers, agents, officials, organisers and representatives from against all claims, actions, demands, and expenses whatsoever concerning death, injury, loss or damage to the undersigned by virtue of his/her participation in said events howsoever caused and regardless of whether same may have been contributed to or occasioned by the negligence of the said bodies, or any of them, their agents, organisers, officials or representatives, and each of the last mentioned parties shall be deemed to be a party to this agreement as if the Royal Manitoba Winter Fair were acting as each party's agent or trustee. Provincial Exhibition of Manitoba and the Show Committee will not be responsible for any accident, injury, damage, loss of or for any other matter that may happen from any cause or circumstance whatsoever, to exhibitors, competitors, members of their families or their agents or to any property brought to the horse show grounds or for any loss claim, matter, circumstance or event whatever in connection with or arising out of or attributable to the horse show or any journey to or from the show. It is hereby recognised that all equestrian sports involved inherent risk and that no helmet or protective equipment can protect against all foreseeable injury. I hereby accept this risk and hold harmless Equine Canada, the competition, their officials, organisers, agents, employees and their representatives.

It is understood and agreed this agreement is to be binding on myself, my heirs, executors and assigns and that I have read and fully comprehended this agreement. I also hereby certify that every horse and rider is eligible as entered, and agree for myself and my representatives to be bound by the constitution and rules of the EC and this show.

Untitled(Required)

I agree to the above

Consent

I hereby certify that every horse listed on this entry form has met the requirements of Ariticle A519, Vaccinations. See Rules of Equestrian Canada, Section A, General Regulations, Article A519, Vaccinations.

Consent

In accordance with Royal Manitoba Winter Fair biosecurity plan, I hereby state that I am in compliance with all guidelines and have submitted proof of equine vaccination when checking in and prior to receiving my competition number.

Signature

Date

RMWF 2023 – Hackney Entry Form

Royal Manitoba Winter Fair

RMWF - Hackney Horse Entry Form

Entries

Pay Prize Money To:

Driver Waiver

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