Great Escape Winter Slide 2011
NRHA, TRHA, & AQHA – Alliance Event
ENTRY # _________
March 5-6, 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
NRHA #________________
G NP Y L
AQHA # ________________
O AM N Y L
NRHA #________________
G NP Y L
AQHA # ________________
O AM N Y L
Payee yes no
Owner’s Name ______________________________________ Payee yes no
SS# ________________________
Rider’s Name ______________________________________ Payee yes no
SS# ________________________
PAYEE: Address_____________________________________________________ City ___________________________ State______ Zip ___________Phone (______)__________________
E-mail _______________________________________________________________ Class Order
Division Class #
Entry Judges Fee Fee
Rider (if different from above)
Pattern #
Office Use Only
Saturday, March 5th , Starting at 8:00 am 1st
1100 1200 1301 1340
_____ _____ _____ _____
Open ($500) Int Open ($250) Ltd Open ($200) AQHA Op Rn
50 25 20 30
25 20
________________________ NRHA # __________
0
________________________ AQHA #__________
2nd
9801
_____
TRHA $1000 Rider 20
20
________________________ TRHA Mem ber
8
NP TRHA
3rd
5300 5310
_____ _____
Rookie I (JP) Rookie II (JP)
20
________________________ NRHA # __________
2
NP Y
4th
1750 1850
_____ _____
Nov Hor Op ($200) 20 Nov Hor NP ($200) 20
20 L2 ________________________ NRHA # __________ L2
3
G NP Y L NP only
20 20
(Only one Judges Fee for Concurrent Classes – Highest fee applies)
8
G NP Y L O AM N Y L
ENTRY # _________ Sunday, March 6th Starting at 8:00 am 1st
5750 5850
_____ _____
Int Hor OP ($200) 20 Int Hor NP ($200) 20
20
________________________ NRHA # __________
6
2nd
3500
_____
10&< Yth Sht Stup 10
0
________________________ NRHA # __________
12 Y YNP
3rd
3100 3200
_____ _____
Yth 13 & < Yth 14–18
10 10
0
________________________ NRHA # __________
2
4347 4348
_____ _____
AQHA 13 & U AQHA 14 - 18
10 10
1400 1500 1600 1650 2340 2348
_____ _____ _____ _____ _____ _____
Non Pro ($500) 50 25 ________________________ NRHA # __________ Int NP ($250) 25 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)
4th
_________________________
AQHA #____________
G NP Y L
Y YNP Y
7
NP only
AM or AM SEL
(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 $80 For Show (3/3-6) - - - - - - - =________ Nightly Stall Fee $30/night - - - - - - - - - - - - =________ Early Arrival (Wed 3/2) $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 - - - - - = ________
________ ________ ___25___
________ ________ ___25___
________ ________ ________ ________ ________
________ ________ ________ ________ ________
________ ________ ________
________ ________ ________
Other Entry forms:
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_____, 2011