ONLY ONE HORSE ON EACH ENTRY BLANK
HORSE NAME
Stall
/
Britannia Farm Horse Show Entry Application
REGISTRATION NUMBER
Ground Fee
YEAR FOALED
SEX
S / G / M Saturday Class Number(s)
Sunday Class Number(s)
Exhibitor AQHA I.D. Number
Open
Name of Exhibitor
Amateur Youth
**Novice Riders see box in lower right hand corner of page
AQHA I.D. Number Expiration Date (mm/dd/yy)
Owner’s Relationship: Youth & Amateur Classes only
Proof of ROM ( Open / Amateur / Youth ) CELL PHONE of participant AT THE SHOW: In case of emergencies or questions ________________________________ Add / Change information to Britannia Farm mailing list YOUTH DATE OF BIRTH __________________________ AMATEUR DATE OF BIRTH________________________ I (We) hereby make application to enter the above named horse (s) in the classes named, subject to the Rules and Regulations of the American Quarter Horse Association, all of which I (We) have read, and agree to the provisions contained therein as a part of this contract. I (We) hereby release the above Show from any claim or loss to myself, employees, horses and/ or equipment.
Lab ____________________ Date Reported ___________ Accession # _____________
Check #___________________
OWNER’S NAME _____________________________________________________________ EXACTLY AS SHOWN ON REGISTRATION PAPERS
ADDRESS __________________________________________________________________ Street or Box #
Town & State
Zip
EMAIL ADDRESS: ____________________________________________________________ NOVICE YOUTH & NOVICE AMATEUR: Circle all appropriate you are eligible Novice
Cash Paid $________________ Total Amount _______________ Open Check (Name)_________________________
A N
B O
C P
D Q
E
F
G
H
I
R
S
T
U
V
Office Fee = $10.00 Ground Fee = $15.00
J W
K
L X
M Y
Drug Fee = $5.00 (per judge) Late Fee = $15.00
Z