entry form, Check, Coggins and signed disclaimer

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NICKE PALSSON DEVELOPING DRIVERS CLINIC
LISA SINGER VSE CLINIC
FEBRUARY 28th through MACRCH 2, 2014
1070/1060 Curb Chain Lane, Windsor, SC 29856
A learning clinic for anyone in any level
NICKE PALSSON has been driving for 35 years representing Sweden. He has won 2 Gold medals
and 1 Silver and 1 Bronze medal at World Four-in-hand Championships. He received the Top Driver
Award in 1993 and has won the National Swedish Championship 9 times. Nicke has been a coach
for USA team at World Championships and recently has been coaching the Spanish Pairs during the
past few years for World Pair Championship. He will be judging this year here in the US at the new
“Kingdom of the Sun” CDE being held at the Florida Horse Park.
LISA SINGER has been driving since 1979 out of Chadds Ford, PA and Windsor, SC. She has
attended 8 World Pair Championships and placed 6 times in the top 12. She has been the 9 times
National Champion, 2 times FEI North America Challenge winner, and 3 times Triple Crown winner.
Lisa has been a coach for singles and ponies for their World Championships and has been a clinician
here in the US. She is also a rated judge. 1997 she was voted The Chronicle Equestrian Horseman of
the Year
This weekend is geared toward learning how to drive better at any level. Ring work will be the
priority and then if you sign up for 2 or more lessons, you can have a chance to work on cones and
obstacles with the clinician—please make sure you have a navigator on hand. Helmets are
recommended for any driving on the premises and required if you drive in an obstacle.
There will be a cones course set up behind the yellow house for practice. So, bring your stopwatch
and have someone time you!! We recommend that for safety purposes that you have someone on
the back, if you would normally be required to do so if competing. Also, we will mark an exercise
trail marked in the Pine Acres woods.—No roads just sand! It will be approximately 5k in distance.
Stabling: We will help find stabling for those who need equine accommodations, ---carriages can
remain on site (if you wish), for the duration of the clinic schedule. Please contact:
Linda Willis 610-698-9413 glenoley@aol.com
Lunch will not be provided so bring your chair and lunch—there are no local restaurants in the
area. Drinks will be provided
Saturday night dinner for participants and their grooms/spouse will be announced later but there
will be a nominal fee.
Auditors $10 per day, Please bring your chairs and lunch. There will be a speaker system for both
rings.
Accommodations: All hotels are within 15 miles of the show. Fairfield Inn 803-648-7808;
Hampton Inn 803-648-2525; Sleep Inn 803-644-9900; Super 8 800-992-2694; Hotel Aiken 803648-4265; Annie’s Inn B&B 803-649-6836.
Directions: If using GPS: “1060 Curb Chain Lane, Windsor, SC” The farms are off of N,
Windsor Rd either 1 mile from State Park RD. or ½ mile off Spring Branch Rd.
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ENTRY FORM
Please print and fill out the next 2 pages. Then with your coggins , signed disclaimer and
check send to:
Lisa Singer , P O Box 302, Windsor, SC 29856
Opening Date (could fill quickly): February 1, 2014
Closing date: February 22, 2014
Name: _______________________________________________________________________________
Address:_____________________________________________________________________________
Email: ____________________________Phone:____________________________________________
Nicke Developing Clinic; : Friday_______ Saturday ______Sunday_______
{ } Single { }Pair { }Multiple
{ }Training { }Preliminary { }Intermediate { }Advanced
Lisa VSE Clinic: Friday_______ Saturday_______ Sunday_______
{ } Single { }Pair { }Multiple
{ }Recreational { } Pleasure Showing
{ } Combined Driving ( ) TR ( ) PR ( ) IT ( ) ADV
Name(s) of Horse/Pony/VSE:
____________________________________________________________________________________________________
Name of groom / navigator: _________________________________________________________________
Fee for clinic: $80 per lesson:
______x $80=________
Auditors who are not grooms:
______x $10 =________
Checks payable to: LISA SINGER
and on Memo line write “Palsson/Singer clinic”
Check enclosed for : $________________
Entries must include: entry form, Check, Coggins and signed disclaimer
(on next page) for whom ever would be on your carriage during the
weekend.
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DISCLAIMER
PALSSON/SINGER CLINIC
2/28—3/1&2/2014
CHATEAU LOG FARM SUD and COURAGE TO LEAD FARM
1070 and 1060 Curb Chain Lane, Windsor Trace
Windsor, SC 29856
HOLD HARMLESS AND LIABILITY RELEASE
Pursuant: “Under South Carolina law an equine activity sponsor or equine professional is not liable
for an injury to or death of a participant in an equine activity resulting from the inherent risk of
equine activity, pursuant to Article 7, Chapter 9 of Title 47 Code of Laws of South Carolina 1976”
I do hereby on behalf of myself and my principals, representatives, employees, and agents that
horse sports, including spectators, drivers, and/or riders, involves inherent dangerous risk of
serious injury or death and by participating, I do so voluntarily and expressly assume any and all
risks of injury or loss, and I agree to indemnify and hold Chateau Log Farm Sud and Courage To
Lead Farm, its owners, members, employees, agents, volunteers and farms associated with this
event harmless from and against all claims including any injury or loss suffered during, or in
conjunction with any activity on these premises, any premises used by the Farms, or any member’s
premises for a Farm related event, whether or not such claim, injury or loss resulted, either directly
or indirectly from the negligent acts or omissions of the Farms, it owners, members, employees,
agents, volunteers, trainers, helpers, and /or organizing committee. I further to agree not to
commence an action or suit, in this or any other jurisdiction, for any such injuries or losses.
I _______________________ have read this Liability Disclaimer and hereby acknowledge that I understand
and agree to its terms and conditions as expressed herein, and will abide by such terms as set forth
above.
Date:___________
Driver signature_____________________________
Print name__________________________
Groom/Navigator signature___________________
Print Name__________________________
Groom/Navigator signature___________________
Print Name___________________________
Parent/Guardian signature if Driver/Groom is a minor__________________________________
Print Name______________________________________________________________
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