PLOWING CONTESTANT ENTRY FORM
& PRIVACY WAIVER
International Plowing Match & Rural Expo
September 16-20, 2014 - Simcoe County - Ivy, Ontario
(Please Print Clearly)
Name: ________________________________________ Date of Birth: __________________
Address: _____________________________________________________________________
Civic Address
_____________________________________________________________________
City
Telephone: __________________________
Postal Code
Email: ________________________________
County of Branch Membership: ______________________________
Class _____ Group _____
Number of Horses Attending the IPM: __________
Number of Years You Have Been Plowing in Competition: ______________
This is to certify that I have received the minimum number of points as stated in Rule 1 of the 2014 Rules &
Regulations Official Handbook. I have enclosed a copy of my certificate of insurance, signed by a company
representative and showing $2 million liability coverage, expiry date and the event named.
Highest Points for 2013 or 2014: __________ received at __________________________ Branch/or previous year
I.P.M. Match.
Please include a copy of the Branch Match Points form from the Branch you received the points, if possible.
Branch Secretary Signature: __________________________________________________
QUEEN OF THE FURROW - Are you interested in coaching a Queen of the Furrow? Yes ____ No ____
Are you committed to a specific County Queen of the Furrow? Yes ____ No ____
If so, what county and the name of the Queen ________________________________________
_____________________________________________________________________________
PLOWING SCHOLARSHIP
Are you interested in the Plowing Scholarship? Yes _____ No ______
***Your County Secretary has the Scholarship Forms – Please contact your County Secretary to complete
the Scholarship Forms and send them into the OPA Office. **All forms are required to be sent to the OPA
Office. (The form the secretary completes as well as the forms you complete.)
Coggins Test if applicable
The Coggins Test is mandatory. Please send a copy of your Coggins Test for your horses when you send in your
entry form. This is due diligence.
ENTRY FEE / DEADLINE
An entry fee of $60.00 must accompany the entry form. ALL entries have to be received by August 15, 2014 or the
envelopes have to be stamped August 15, 2014.
Make cheques payable to: Ontario Plowmen’s Association
*NSF Cheques – there will be a charge of $25 for a NSF cheque.
If paying by credit card: Visa / Master Card ___________________________________________________
Expiry Date: ___________________
3 Security Numbers on Back of Card: __________
ALL entries have to be received by August 15, 2014 or the envelopes have to be stamped August 15, 2014.
Certificate of Insurance has to be received with the entry in order to be accepted.
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***Rules & Regulations Book – The 1st page of the Rules & Regulations book list the changes
and or additions to the Rules & Regulations in 2014.
INSURANCE
If you are borrowing equipment for the competition, please provide the following:
Name of Owner: _______________________________________________________
Phone Number of Owner: ________________________________________________
The owner, as well as the contestant, must supply an insurance certificate signed by a company representative
showing $2 Million liability coverage, expiry date and the event named.
***Mandatory: Please send in a Certificate of Insurance with your entry form.
Practice Fields
As per Rules & Regulations Book – page 8 - Practice Plowing – this will be held on Monday only - prior to the IPM.
One – (1) land per competitor. Lots will be assigned when requested.
***Note: ALL of the ‘Practice Land’ has to be totally plowed.
In order to calculate the number of lands that will be needed for plowing and practice lands we need to know if you
will require practice land on Monday, September 15, 2014.
Please check off whether or not you require a practice land.
Yes
No
Privacy Waiver
The O.P.A. maintains a database of participants annually in order to keep all interested individuals up to date on
activities of the O.P.A. and the I.P.M. including matches, special events, programs, services and the delivery of prize
money. Photos taken at O.P.A. and I.P.M. events may be used to promote O.P.A., I.P.M. and other special events
through the O.P.A. website and other promotional materials.
By participating in this event you are consenting to allow your name to be listed on the website and possibly
being used on other promotional material.
This information will not be sold or made available outside of the O.P.A.
For further information or to have specific names removed from our database please contact our Privacy
Compliance Officer via the information above or at eventadmin@plowingmatch.org
I _____________________________________ hereby give permission to allow the O.P.A. to maintain my / my son’s
/ daughter’s contact information within their internal database and to publish photos of myself / my son / daughter
along with a listing of points earned at the match.
_________________________________________
Signature of Competitor or Parent / Guardian
If Competitor is under 18 years of age
_________________________
Date
If you require a receipt please check here
Yes ____ No ____
Check-off List
(Just a reminder to make sure all requirements are completed)
 Certificate of Insurance enclosed
 Class 6 – Antique Tractor Form
 Entry Fee enclosed
 Entry Form completed – full mailing address
 # of Horses Attending the IPM
 Copy of the Coggins Test paperwork if applicable
 Scholarship paperwork completed if applicable
 Practice lot – checked off
(Please no faxes)
Any questions, please don’t hesitate to contact the OPA Office – 519-767-2928: 1-800-661-7569
eventadmin@plowingmatch.org
Please mail paperwork and payment to:
Ontario Plowmen’s Association, 188 Nicklin Rd., Guelph, ON N1H 7L5
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