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 Friday Class Number(s)
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 ________________________________ YOUTH DATE OF BIRTH __________________________ AMATEUR DATE OF BIRTH________________________ I agree neither Great Southwest Equestrian Center LP, nor Britannia Farm, nor Pauline Cook, nor the Show Committee, nor the officials and/or staff of the show will be responsible for any accident, damage, loss or injury to count, owner, rider or other persons or property. It will be the condition of entry that each exhibitor shall hold the horse show and its management blameless for any loss or accident to any animal, person or property that may occur from sickness, fire and otherwise at this show. Under Texas law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities.
Check #___________________
Lab ____________________
Add / Change information to Britannia Farm mailing list 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 A
B
C
D
E
F
G
H
I
R
S
T
U
V
J
K
L
M
Cash Paid $________________
Date Reported ___________ Total Amount _______________ Accession # _____________ Open Check (Name)_________________________
N
O
P
Q
Office Fee = $10.00
W
X
Y
Drug Fee = $5.00 (per day)
Z
Ground Fee = $15.00