Gold Coast Race Series

Permit Application 2008-2009

(Fill out one application for each horse.)

Applicant’s Name:_______________________________________

Horse’s Name: _________________________________________

(Print horse’s name as it will appear on the entry card)

Mailing Address:_____________City:__________ State:______Zip:_________

Telephone Number (Day): _________________

Telephone Number (Night): ________________

E-mail Address: ________________________________________ (Where all race results and Gold Coast Information will be sent)

Permit is for (circle one): Primary Horse ($45) Second Horse ($25) Third Horse ($25)

In submitting my Permit Application, I hereby acknowledge receipt of and fully understand the 2007 - 2008 Gold Coast Race Rules and Information. I promise to comply with all rules listed therein. I release the show organizer, any and all clubs or organizations thereof, property owners, arena owners, arena operators, any officials, employees, directors or agents of same, and anyone else from any claim or right for damages which may occur to me, my horse, my child, or other property at all said shows. I agree to be fully responsible and forfeit any or all monies and entry fees should damage result from my horse(s), myself, or any of my traveling companion’s actions. I also fully understand and acknowledge there are certain risks in any sport and take complete responsibility for myself, my horse(s) and or my child should an incident occur. I agree to display good sportsmanship at all times. Animal abuse will not be tolerated. Inappropriate language, misconduct, or abusive comments spoken to any contestant, spectator, event staff member, or volunteer will result in immediate contestant disqualification and no refund of entry fees.

Signature: (Must be signed by parent/guardian for minors age 17 and under.)

X _______________________________________ Date: ______________________________

Signature of minor if signed by parent/guardian above: X_______________________________

Mail Check or Money Order (No Cash) to: Express Equine/Gold Coast Races

14905 Olive Avenue, Morgan Hill, CA 95037

For Office Use: ______ Date Card Issued, Circle One: Check No. ______, or Cash

Cards with Permit Number will be sent within 14 days upon receipt of Permit Application. E mail or call for more information: ExpressHay@aol.com , (408) 779-6621