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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