French Creek Pony Club Open Derby
Saturday August 15, 2015
Questions? Contact Barbara Massey at
dbmassey@hotmail.com
Please join us for a fun day of dressage and jumping at beautiful
Polestar Farm – 15531 64th St., Lake Stevens, WA 98258
Jumping/cross country clinic with Meika Decher on Sunday, August 16!
www.polestarfarm.com for directions and clinic information
Divisions - Enter up to two divisions; schooling rounds allowed after divisional ride.
Riders may choose to enter only
dressage or only jumping at any level. Divisions will be combined or divided as needed. Jumping not timed.
Grasshopper
Jumps to 18”
2015 USDF Intro Test A
(in separate fenced field)
Hopeful
Beginner Novice
Novice
Training
Jumps to 2’
Jumps to 2’6”
Jumps to 2’11”
Jumps to 3’3”
2014 USEF BN Test A
2014 USEF BN Test A
2014 USEF Novice Test A
2014 USEF Training Test A
HELMETS & MEDICAL ID REQUIRED FOR ALL RIDERS
7:00 AM
8:30 AM
Show office opens; warm-up arena open
Dressage tests begin; covered small arena (20mx40m) on hogfuel
If entries warrant, a 2nd dressage grass arena may be added for Intro and schooling tests.
10:00 AM Jumping begins with lowest heights; courses posted Saturday AM
 The goal of this show is to provide a fun, low-stress, positive experience – perfect for new riders, green
horses, or trying out a higher level.
 Modified rules (same as 2014) allow you to continue with penalty points instead of elimination. For complete
rules see our web page at frenchcreekpc.com
 Ride times will be posted online and emailed by 8pm Aug 13 – please make sure your email address is legible!
 Jump vests are suggested, but not required. Dress is appropriate schooling attire.
 Ribbons 1st to 8th place; prizes for top scores
 Limited day and overnight stalls. Free on-site camping (no hookups). No Dogs, please
 Concessions on-site
Entries must be postmarked by August 8
Discount for Pony Clubbers and walk/trot Grasshopper division!
French Creek Pony Club Open Derby at Polestar Farm – August 15, 2015
Visit frenchcreekpc.com for dressage tests, ride times, and rules
Rider Name: ___________________________________________________ Age:____________________ (as of 1/1/15)
Address: _________________________________________________________________________________________
Phone: ___________________________________________ Email: _________________________________________
Required in order to email ride times and announcements
Horse Name: ________________________(one form for each horse)
 USPC Member /Club Name:________________
 Derby only –dressage test and jump round
 Derby and schooling at discounted rate - $20 dressage test /$20 XC round
 I want to do schooling rounds only - $25 dressage test / $25 XC round; priority given to derby entrants
Derby Division – Grasshopper Division discounted entry fee of $60
Division #1: Grasshopper Hopeful BN
Novice Training
Division #2: Grasshopper Hopeful BN Novice Training
___# div x $75/60 ____________
Dressage Schooling – Additional or Separate Tests; except for Intro, all tests are 2014 USEF, Test A
Test #1: Intro-A
BN-A
Novice-A
Training-A
Test #2: Intro-A
BN-A
Novice-A
Training-A
_____# tests x $20/25 ____________
XC Jump Schooling – Non-divisional or schooling rounds to be completed at the end of each division.
Round #1 :  18”
 2’
 2’6”
 2’11”
Round #2 :  18”
 2’
 2’6”
 2’11”
 3’3”
 3’3”
See next page for stall & camping reservation
Submit separate check to Polestar for stall fees
_____# rounds x $20/25 ____________
$25 Facility Fee (per horse)
$25
$5 Discount for USPC Members
(________)
$15 Late Fee after Aug 8
MAKE CHECKS PAYABLE TO FRENCH CREEK PONY CLUB (FCPC)
_________
TOTAL ____________
**Refunds after closing, less $20 admin fee, only with Vet/Dr. Certificate**
RELEASE:
Whereas, the undersigned acknowledges the inherent risks involved in riding and working around horses, which risks include bodily injury
from using, riding or being in close proximity to horses, among other risks, and that both horse and rider can be injured in normal use or in competition and
schooling; In consideration, for the privilege of riding, and/or working around horses at Polestar Farm, the undersigned agree to hold harmless and indemnify
Polestar Farm, all owners and employees and release them from liability or responsibility for accident, damage, injury, or illness to the undersigned or any horse
owned by the undersigned or to any family member or spectator accompanying the undersigned on the premises of Polestar Farm.
Signature: ___________________________________________
Date: _______________________
Competitor or Parent/guardian if under 18 yrs.
Non-Pony Club competitors will need to sign the General Activity Release for USPC Non-Members
at the show office before picking up packets. Medical ID required for ALL riders.
Entries due by
Mail Completed Entries to:
Aug 8
French Creek PC Derby
th
16109 -88 St SE, Snohomish, WA 98290
No Question too Small
Barbara Massey, JtDC 206.229.1720
dbmassey@hotmail.com
STALL & CAMPING RESERVATION
FCPC DERBY AT POLESTAR FARM
AUGUST 15, 2015
A limited number of stalls are available, reserved for the time periods specified below. Bedding
provided for inside stalls. Outside stalls are not covered, and have dirt/grass floors. If you are
planning to stay overnight, get your stall payment in early as stall assignments are first come
first served!
Rider Name: ___________________________________________ Horse Name:______________________________
Stall with: _______________________________________________________________________________________
Inside Stalls – No doors, bring stall guard!
 Friday overnight, inside barn ($25): Friday 4pm – end of derby on Saturday
 Saturday overnight, inside barn ($25): Saturday end of derby - Sunday 4pm
 Weekend, inside barn ($40): Friday 4pm - Sunday 4pm
Outside Stalls
 Friday overnight, outside ($15): Friday 4pm – end of derby on Saturday
 Saturday overnight, outside ($15): Saturday end of derby - Sunday 4pm
 Weekend, outside ($25): Friday 4pm - Sunday 4pm
Please make check out to Polestar Farm for amount of stall fee(s)

CAMPING
Free on-site camping in parking field Friday & Saturday night; no hook-ups
Check which night(s):
 Friday
 Saturday

No arrivals prior to 4pm on Friday. The XC course and dressage arenas will be closed to all
schooling on Friday.
Send this form in with your derby entry and payment.
Mail Completed Entries by Aug 8 to:
French Creek PC Derby
16109 -88th St SE, Snohomish, WA 98290
No Question too Small
Barbara Massey, JtDC 206.229.1720
dbmassey@hotmail.com