Janet Read Memorial Miniature Horse Show

OWNER INFORMATION

Name _____________________________

Address ___________________________

Owner/Agent/Lessee Phone #_____________

Is Horse Leased ____ No ____Yes
If Yes (provide AMHA verification)

Equestrian Center of Walnut Creek
Walnut Creek, CA

Send Entries to: Kim Suddaby
PO Box 214
Clayton, CA 94517

Make Checks Payable to Equestrian Center of Walnut Creek

REGISTER ONLINE AT www.horseNpony.com/equestriancenter

Name of Horse	Registration #	Entry #	Handler’s Name	Classes Entered

Age Color Sex

Age Color Sex

Age Color Sex

YOUTH HANDLER’S BIRTHDATE _____________________

Every entry at this show shall constitute an agreement that the person making it shall::

be subject to the rules of the show
that every horse and handler is eligible as entered
that the owner, handler, and any of their agents or representatives agree to hold

The show management , Show officials, Show Facility, Agents and the Equestrian Center of Walnut Creek Harmless for any injury or loss suffered during or in connection with the show.

I have read the above and agree to be bound by them and the rules of the show and hereby accept the responsibility under these rules for the participation of any minur under my supervision.

Signature_________________________________________________

Amateur/Youth Handler’s Name AMA/Youth #

_________________________________________________________

ENTRIES CLOSE JUNE 20TH

POST ENTRY FEE 5.00

___	Classes X $30.00 =	$__________
___	Horses x $4.00 =	$__________
___	Drug fee x $5.00 =	$__________
___	Post Entry fee X $5.00 =	$__________
TOTAL AMOUNT DUE		$__________