Great Escape 2013

NRHA, TRHA, STRHA ENTRY # _________ March 1-3, 2013 Great Southwest Equestrian Center, Katy, Texas Check # _______ Open Closed Account Name: ________________________________________PAID Check $________ PAID Cash $________ (Person Responsible for Paying)

Trainer: ________________________________ NRHA Horse’s Name _____________________________________ Comp Lic # ______________ S G M Horse’s Barn Name _____________________ Yr Foaled:_____JR SR Negative Coggins Accension # ______________ neg ____/____/____ Owner’s Name ______________________________________ NRHA # ________________ G NP Y L SSN# _____________________

Owner’s Name ______________________________________ NRHA # ________________ G NP Y L SSN# _____________________ Rider’s Name ______________________________________ NRHA # ________________ G NP Y L SSN# _____________________

NO ADDRESS….NO SSN#.....NO PAYCHECK PAYEE: Rider or Owner Address_____________________________________________________ City ___________________________ State______ Zip ___________Phone (______)__________________

E-mail _______________________________________________________________ Class Division Entry Judges Order Class # Fee Fee Rider (if different from above) Pattern # Office Use Only Friday, Mar 1st , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 ________________________ NRHA #__________ 2 G NP Y L 9004 Mens (JP) 20 (class may be limited to 20 entries)

2nd 1100 Open ($1000) 100 35 ________________________ NRHA # __________ 6 G NP Y 1200 Int Open ($500) 50 25 1301 Ltd Open ($250) 25 20 1350 Rookie Pro (JP) 25 20

3rd 5850 Int Hor NP ($250) 25 20 ________________________ NRHA # __________ 9 NP YNP

4th 10001 Green Level II 20 0 ________________________ NRHA # __________ 4 G Y A 10002 Green Level I 20

Saturday, Mar 2nd , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 ________________________ NRHA #__________ 8 G NP Y L 9004 Mens (JP) 20 (class may be limited to 20 entries)

2nd 1700 Nov Hor Op L1($200) 20 20 ________________________ NRHA # __________ 5 G NP Y 1750 Nov Hor Op L2($250) 25

Horse Name____________________________________ ENTRY # _________ 3rd 1800 Nov Hor NP L1 ($200) 20 20 ________________________ NRHA # __________ 5 NP Only 1850 Nov Hor NP L2 ($250) 25

4th 3500 Yth 10 < Short Stir 10 0 ________________________ NRHA # __________ 12 Y YNP

5th 3100 Yth 13 & < 10 0 ________________________ NRHA # __________ 2 Y YNP 3200 Yth 14–18 10

6th 9801 $1000 TRHA/STRHA 20 20 ________________________ TRHA Member 8 NP TRHA Novice Rider (JP) ________________________ STRHA Member NP STRHA Sunday, Mar 3rd , Starting at 8:00 am 1st 9003 Ladies (JP) 20 20 ________________________ NRHA #__________ 6 G NP Y L 9004 Mens (JP) 20 (class may be limited to 20 entries)

2nd 1400 Non Pro ($1000) 100 35 ________________________ NRHA # __________ 8 NP only 1500 Int NP ($500) 50 25 1600 Ltd NP ($200) 20 20 1650 PT N Pro ($200) 20

3rd 5300 Rookie I (JP) 20 20 ________________________ NRHA # __________ 8 NP Y 5301 Prime Time Rookie (JP) 20 5310 Rookie II (JP) 20 (*PT Rookie must also enter Rookie Level 1 or 2)

4th 5750 Int Hor OP ($250) 25 20 ________________________ NRHA # __________ 10 G Y

(Only one Judges Fee for Concurrent Classes – Highest fee applies) Charges FOR OFFICE USE ONLY Entry fee total - - - - - - - - - - - - - - - - =________ ________ ________ Judges fee total - - - - - - - - - - - - - - - - =________ ________ ________ Office fee $25 - - - - - - - - - - - - - - - - - - =___25___ ___25___ ___25___ (Youth Only Classes-office fee free) Stall _____ X $110 For Show (2/26-3/2) - - - - - =________ ________ ________ Early Arrival (Mon 2/25) $30/stall - - - - - - - - =________ ________ ________ Three night stall _____ X $90 - - - - - - - - - - =________ ________ ________ Two night stall _____ X $60 - - - - - - - - - - - =________ ________ ________ One night stall _____ X $40 - - - - - - - - - - - =________ ________ ________ Stall/Ground Fee____ X $40 Per _____ DAY - - =________ ________ ________ Shavings _____ bag(s) X $11 per bag - - - - - =________ ________ ________ (must be purchased from GSEC) Paid Warm Ups _____X $25 for 8 min - - - - - - =________ ________ ________ RV Space ______ X $30 per ____ Nights - - - - =________ ________ ________ FINAL TOTAL = _________ _________ _________

WARNING: Under Texas Law (Chapter 87, Civil Practice and Remedies Code), an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities. I further understand that all horses must be stalled due to facility requirement. Horses are not allowed to be tied to trailers for extended periods or overnight. I will abide by this requirement Signature: ___________________________________________ Date: March_____, 2013

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