| Show Date: |
|
Horse Owner Name:
date of birth required if 17 and under |
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| Horse Owner Address: |
|
| City State Zip: |
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| Horse Owner Email Address: |
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| Horse Owner Phone: |
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| Alternate Phone: |
|
| |
Non Member |
| |
Member |
Horse Name:
Note: horses names cannot be changed throughout the year, please use same name (spelling) each time to qualify for year end points |
|
| Horse Age, Sex, Breed, Color: |
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| Rider/Handler Name: |
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| Rider/Handler Address: |
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| City State Zip: |
|
Rider/Handler Date of Birth
(required if 17 and under): |
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| Rider/Handler Email Address: |
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| Rider/Handler Phone: |
|
| Alternate Phone: |
|
| |
member |
| |
non member |
Class Entry Numbers:
please list all class numbers you wish to enter |
|
| Non Showing Horse Fee $20.00: |
|
| Day Stall $20.00: |
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| Daily Class Sponsor $30.00: |
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| Club Sponsorship @ any $: |
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| Name On Credit Card: |
|
Credit Card Number:
visa, mastercard, discover |
|
| Credit Card Expiration Date: |
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| Address for Credit Card: |
|
| City State Zip: |
|
| |
