$1,000!WPRA!Pro!Elite!Sire!Incentive!Bonus! EntryForm& Norris&Penrose… · 2015-02-27 ·...

2015  Horse  Hair  Analysis  $2000  added  Derby  $1,000  WPRA  Pro  Elite  Sire  Incentive  Bonus  

Entry  Form  Norris  Penrose  Event  Center,  Colorado  Springs  Colorado  

One  entry  per  horse    Name  of  Horse:  _________________________________________________________  Sex  ______________________    Age  _____________  Sire  _________________________________Dam_________________________________________    Owners  Name  _____________________________________________  SS  Number:  __________________________      Address_______________________________________________  City,  State,  Zip  _____________________________    Riders  Name  _______________________________________  SS  Number:  __________________________________      Address_______________________________________________  City,  State,  Zip  _____________________________    Contact  Phone  Number  _______________________________  Email  _____________________________________    WPRA  #  ___________________________________________  BBR  #__________________________________________    Checks  made  out  to:  ______________________________________________PESI:_______Y    /      N______________    I (We) hereby make application to enter the above named horse in the Colorado Classic Futurity/ Derby/Side-Pots subject to the Colorado Classic and MHBHA rules, all of which I (we) have read and agree to the provisions contained therein as part of this contract. I (We) hereby release Colorado Classic, Mile Hi Barrel Horse Association and their employees from any claim or loss to rider or horses, employees, equipment and/or myself.  ______________________________________________________________________________    _______________________________  Derby  Contestant  Signature                                                                                                                                                                Date      Please  include  front  and  back  photocopy  of  registration  papers  or  veterinarians  affidavit  to:    Colorado  Classic  Futurity  and  Derby,  1300  S.  Bonnie  Lane,  Watkins,  CO  80137      Derby  Payment  Schedule:    May  1st  -­‐  $90                                                                                                          June  1st  -­‐  $90    $25  fee  will  be  assessed  to  all  payments  postmarked  after  the  due  dates;  $60  total  late  fee  for  entry  at  event.  Please  include  ONE  TIME  PER  RIDER  $25  Processing  fee  to  first  payment  for  the  event.  If  you  

have  paid  this  with  your  open  or  futurity  entry,  you  are  done!    OFFICE  USE  ONLY       Date  Paid   Amount     Late  Charges   Balance  May  1st                    June  1st