Friday Class

Number(s)

Saturday Class

Number(s)

Sunday Class

Number(s)

Name of Exhibitor

**Novice Riders see box in lower right hand corner of page

Open

Amateur

Youth

Exhibitor AQHA I.D. Number

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

Add / Change information to Britannia Farm mailing list

ONLY ONE HORSE ON EACH ENTRY BLANK

HORSE NAME

Check #___________________ Cash Paid $________________

OWNER’S NAME _____________________________________________________________ EXACTLY AS SHOWN ON REGISTRATION PAPERS

ADDRESS __________________________________________________________________ Street or Box # Town & State Zip

YOUTH DATE OF BIRTH __________________________

AMATEUR DATE OF BIRTH________________________

NOVICE YOUTH & NOVICE AMATEUR: Circle all appropriate you are eligible Novice

A B C D E F G H I J K L M

N O P Q R S T U V W X Y Z

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 acci-dent, damage, loss or injury to count, owner, rider or other persons or property. It will be the condi-tion 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 other-wise 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 inher-ent risks of equine activities.

SEX REGISTRATION NUMBER YEAR FOALED

Britannia Farm Horse Show Entry Application

Lab ____________________ Date Reported ___________ Accession # _____________

Stall / Ground Fee

Total Amount _______________

EMAIL ADDRESS: ____________________________________________________________

S / G / M

Open Check (Name)_________________________ Office Fee = $10.00 Drug Fee = $5.00 (per show day) Ground Fee = $15.00