/quarter%20horse%20entry%20blank%202012

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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 ) _____# of Stalls _____ # shavings ___# of RV x ____Nights CELL PHONE of participant AT THE SHOW: In case of emergencies or questions ________________________________

Add AQHA Membership at show 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.

Lab ____________________ Date Reported ___________

Check #___________________

Add / Change information to Britannia Farm mailing list OWNER’S NAME _____________________________________________________________ EXACTLY AS SHOWN ON REGISTRATION PAPERS

ADDRESS __________________________________________________________________ Street or Box #

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 $________________ Total Amount _______________

Accession # _____________

Town & State

Open Check (Name)_________________________

N

O

P

Q

Office Fee = $10.00

W

X

Y

Drug Fee = $5.00 (per show day)

Z Ground Fee = $15.00


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