Great Escape 2013 NRHA, TRHA, STRHA
ENTRY # _________
March 1-3, 2013 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 # ______________
S G M Yr Foaled:_____JR SR
Horse’s Barn Name _____________________ Negative Coggins Accension # ______________
neg ____/____/____
Owner’s Name ______________________________________ SSN# _____________________
NRHA # ________________
G NP Y L
Owner’s Name ______________________________________ SSN# _____________________
NRHA # ________________
G NP Y L
Rider’s Name ______________________________________ SSN# _____________________
NRHA # ________________
G NP Y L
NO ADDRESS….NO SSN#.....NO PAYCHECK PAYEE: Rider or Owner Address_____________________________________________________ City ___________________________ State______ Zip ___________Phone (______)__________________
E-mail _______________________________________________________________ Class Order
Division Class #
Entry Judges Fee Fee
Friday, Mar 1st , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 9004 Mens (JP) 20 (class may be limited to 20 entries) 2nd
1100 1200 1301 1350
3rd
5850
4th
10001 10002
1700 1750
Office Use Only
Pattern #
________________________ NRHA #__________
2
G NP Y L
100 50 25 25
35 25 20 20
________________________ NRHA #__________
6
G NP Y
Int Hor NP ($250)
25
20
________________________ NRHA #__________
9
NP YNP
Green Level II Green Level I
20 20
0
________________________ NRHA #__________
4
GYA
________________________ NRHA #__________
8
G NP Y L
________________________ NRHA #__________
5
G NP Y
Open ($1000) Int Open ($500) Ltd Open ($250) Rookie Pro (JP)
Saturday, Mar 2nd , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 9004 Mens (JP) 20 (class may be limited to 20 entries) 2nd
Rider (if different from above)
Nov Hor Op L1($200) 20 Nov Hor Op L2($250) 25
20
Horse Name____________________________________ 3rd
1800 1850
Nov Hor NP L1 ($200) 20 Nov Hor NP L2 ($250) 25
4th
3500
Yth 10 < Short Stir
5th
3100 3200
Yth 13 & < Yth 14–18
6th
9801
ENTRY # _________ NP Only
20
________________________ NRHA #__________
5
10
0
________________________ NRHA #__________
12 Y YNP
10 10
0
________________________ NRHA #__________
2
Y YNP
$1000 TRHA/STRHA 20 Novice Rider (JP)
20
________________________ TRHA Member ________________________ STRHA Member
8
NP TRHA NP STRHA
________________________ NRHA #__________
6
G NP Y L
Sunday, Mar 3rd , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 9004 Mens (JP) 20 (class may be limited to 20 entries) 2nd
1400 1500 1600 1650
________________________ NRHA #__________
8
NP only
3rd
5300 5301 5310
Rookie I (JP) 20 20 ________________________ NRHA #__________ Prime Time Rookie (JP) 20 Rookie II (JP) 20 (*PT Rookie must also enter Rookie Level 1 or 2)
8
NP Y
4th
5750
Int Hor OP ($250)
10 G Y
Non Pro ($1000) Int NP ($500) Ltd NP ($200) PT N Pro ($200)
100 35 50 25 20 20 20
25
20
________________________ NRHA #__________
(Only one Judges Fee for Concurrent Classes – Highest fee applies) Charges
Checks payable to: GSEC
FOR OFFICE USE ONLY
Entry fee total - - - - - - - - - - - - - - - Judges fee total - - - - - - - - - - - - - - - Office fee $25 - - - - - - - - - - - - - - - - - (Youth Only Classes-office fee free) Stall _____ X $110 For Show (2/26-3/2) - - - - Early Arrival (Mon 2/25) $30/stall - - - - - - - Three night stall _____ X $90 - - - - - - - - - Two night stall _____ X $60 - - - - - - - - - - One night stall _____ X $40 - - - - - - - - - - Stall/Ground Fee____ X $40 Per _____ DAY - Shavings _____ bag(s) X $11 per bag - - - - -
=________ =________ =___25___
________ ________ ___25___
________ ________ ___25___
=________ =________ =________ =________ =________ =________ =________
________ ________ ________ ________ ________ ________ ________
________ ________ ________ ________ ________ ________ ________
Paid Warm Ups _____X $25 for 8 min - - - - - - =________ RV Space ______ X $30 per ____ Nights - - - - =________
________ ________
________ ________
_________
_________
(must be purchased from GSEC)
FINAL TOTAL =
_________
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: March_____, 2013