East Meets West Fall Slide 2011
NRHA, TRHA, & AQHA – Alliance Event
ENTRY # _________
October 7-9, 2011 Great Southwest Equestrian Center, Katy, Texas
Check # _______ Open Closed Account Name: ________________________________________PAID Check $________ PAID Cash $________
(Person Responsible for Paying)
Trainer:
________________________________
NRHA Horse’s Name _____________________________________ Comp Lic # ______________ AQHA # ________________ Negative Coggins Accension # ______________
S G M Yr Foaled:_____ JR SR neg ___/___/___
Owner’s Name ______________________________________
NRHA # ________________
G NP Y L
SS# ________________________
AQHA # ________________
O AM N Y L
Owner’s Name ______________________________________
NRHA #________________
G NP Y L
SS# ________________________
AQHA # ________________
O AM N Y L
Rider’s Name ______________________________________
NRHA #________________
G NP Y L
SS# ________________________
AQHA # ________________
O AM N Y L
Payee yes no
Payee yes no
Payee yes no
PAYEE: Address_____________________________________________________ City ___________________________ State______ Zip ___________Phone (______)__________________
E-mail _______________________________________________________________ Class Order
Division Class #
Friday, Oct 7th , Starting at 8:00 am 1st 1100 Open ($650) 1200 Int Open ($300) 1301 Ltd Open ($200) 1340 AQHA Op Rn
Entry Judges Fee Fee
Rider (if different from above)
Pattern #
60 30 20 30
25 25 20 0
________________________ NRHA #__________
________________________ AQHA #__________
Office Use Only
9
G NP Y L
O AM N Y
2nd
1750
Nov Hor Op ($250) L2 25
20
________________________ NRHA #__________
2
G NP Y L
3rd
9500
Green as Grass
20
20
________________________ NRHA #__________
2
NP TRHA
20 20
20 20
________________________ NRHA #__________ ________________________ TRHA Member
8
NP Y NP TRHA
Saturday, Oct 8th , Starting at 8:00 am 1st 5300 Rookie I (JP) 9801 TRHA $1000 Rider 2nd
5301 5310
Prime Time Rookie (JP) 20 Rookie II (JP) 20
20
________________________ NRHA #__________
4
NP Y
3rd
9500
Green as Grass (JP)
20
________________________ NRHA #__________
6
TRHA
25
(Only one Judges Fee for Concurrent Classes – Highest fee applies)
ENTRY # _________
Sunday, Oct 9th Starting at 8:00 am 1400 1500 1600 1650 2340 2348
2nd
3500
Yth 10 & < Short Stir 10
0
________________________ NRHA #__________
12 Y YNP
3rd
3100 3200
0
________________________ NRHA #__________
7
4347 4348
Yth 13 & < Yth 14–18 AQHA 13 & U AQHA 14 – 18
10 10
5750 5850
Int Hor OP ($250) Int Hor NP ($250)
25 25
1st
4th
Non Pro ($650) 60 25 ________________________ NRHA #__________ Int NP ($300) 30 20 Ltd NP ($200) 20 PT N Pro ($200) 20 AQHA Am Rein* 30 0 ________________________ AQHA #__________ AQHA Am Select* 30 (*AQHA Riders may enter only Amateur or Amateur Select – NOT Both)
10 10
_________________________
20
5
AM or AM SEL
Y YNP Y
AQHA #____________
________________________ NRHA #__________
NP only
6
G NP Y L
(Only one Judges Fee for Concurrent Classes – Highest fee applies) Charges
Checks payable to: Great Southwest Eq Cntr
FOR OFFICE USE ONLY
Entry fee total - - - - - - - - - - - - - - - - =________ Judges fee total - - - - - - - - - - - - - - - - =________ Office fee $25 - - - - - - - - - - - - - - - - - - - - - - - = ___25___ (Youth Only Classes-office fee free) Stall _____ X $110 For Show (10/4-8 night) - - = ________ Nightly Stall Fee $30/night - - - - - - - - - - - -= ________ Early Arrival (Mon 10/3) $30/stall - - - - - - -- = ________ Stall/Ground Fee____ X $40 Per _____ DAY - -= ________ Shavings _____ bag(s) X $11 per bag - - - - - -= ________ (must be purchased from GSWEC) Paid Warm Ups _____X $25 for 8 min - - - - - - =________ RV Space ______ X $30 per ____ Nights - - - = ________ AQHA Drug Testing $5.00/horse/show - - - - - = ________
FINAL TOTAL =
________ ________ ___25___
________ ________ ___25___
________ ________ ________ ________ ________
________ ________ ________ ________ ________
________ ________ ________
________ ________ ________
_________
_________
_________
WARNING: Under Texas Law (Chapter 87, Civil Practice and Remedies Code), an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities. I further understand that all horses must be stalled due to facility requirement. Horses are not allowed to be tied to trailers for extended periods or overnight. I will abide by this requirement Signature: ___________________________________________
Date: October_____, 2011