Pre-Entry Form Texas Classic Working Western Series TEAM PENNING/RANCH SORTING ENTRY FORM

Transcription

1 Pre-Entry Form Texas Classic Working Western Series TEAM PENNING/RANCH SORTING ENTRY FORM Complete the form below and FAX or mail with copy of AQHA reg. papers & membership card to: Attn: Kensey Hayes 1101 W. Anderson Lane Austin, TX FAX: Responsible Party: Horse Information: (as it appears on AQHA Registration Certificate) Registered Name: Registration No: Year foaled: Sex: S M G Owner Information (as it appears on AQHA Registration Certificate) Owner Name: AQHA ID# Expiration Date: Address: City/State/Zip Exhibitor Information: Open Exhibitor Name: AQHA ID # Exp. Amateur Exhibitor Name: AQHA ID # Exp. Youth Exhibitor Name: AQHA ID# Exp. CLASSES ENTERED: Circle all for one horse; must complete form for each horse entered Entry Fee: $50 per judge INCLUDES CATTLE FEE! (20 % payback) $5 AQHA drug testing fee Team Penning 1630 OP 2630-AM 2638 SEL YT Ranch Sorting OP AMA SEL YT *USTPA: $30 co-sanction fee per horse List other team members: MUST BRING COPY OF AQHA REGISTRATION CERTIFICATE & MEMBERSHIP CARD Upon entering, you hereby release this show, the sponsors, their offices, show management and AQHA from any claim or right for damages to yourself, your employees, horse(s) and equipment. You also accept full responsibility for all show fees incurred by you and your horse(s). Signature:

2 Texas Classic Working Western Series TX Submit Entry (Postmarked by May 15 th ) to: Kensey Hayes 1101 W. Anderson Lane, Austin, khayes@tqha.com Phone: (512) Stalling & RV Reservations call Barbara Linke: (512) NRHA- Approved AQHA- Alliance Event Entry # May 24 25, 2011 * Will Rogers Memorial Center, Ft. Worth, TX Account Name: (Person Responsible for Paying) NRHA Horse s Name: Check # open closed PAID Check $ PAID Cash $ Comp Lic # AQHA Horse s Name: AQHA # S G M Negative Coggins Accension # Owner s Name: NRHA # G NP Y L Payee yes no SS# AQHA # O AM N Y L Owner s Name: NRHA # G NP Y L Payee yes no SS# AQHA # O AM N Y L Rider s Name: NRHA # AQHA # Payee yes no SS# PAYEE: Address Phone ( ) - City State Zip Class Order Division Class# Added Entry Fee Judges Fee Rider (if different from above) Pattern # Office Use Tuesday, May 24 th Starting at 8:00 am - John Justin Arena 1 st 400 NRHA/AQHA Open Reining - $54 - AQHA # 9 O Am. N Y 409 NRHA Intermediate Open $500 $50 $20 NRHA # 9 G NP Y L 410 NRHA Limited Open $500 $50 $ nd 414 NRHA Limited Non Pro $200 $20 $20 NRHA # 10 Non Pro Only 415 NRHA Intermediate Non Pro $500 $50 $ NRHA Prime Time Non Pro Jackpot $30 $ NRHA Non Pro $1000 $100 $ rd 418 NRHA Nov. Horse Open- L1 $200 $20 $20 NRHA # 8 G NP Y L 419 NRHA Nov. Horse Open- L2 $500 $50 $ NRHA Snaffle Bit/Hackamore $250 $25 $0 8

3 Wednesday, May 25 th Starting at 8:00 am John Justin Arena 1 st 406 NRHA Nov. Horse NP- L1 $200 $20 $20 NRHA # 6 Non Pro Only 407 NRHA Nov. Horse NP- L2 $500 $50 $ AQHA Am. Select Reining - $54 - AQHA # 6 Am. Am Sel 403 AQHA Amateur Reining - $ nd 420 NRHA Youth 13 & Under Jackpot $10 $0 NRHA # 5 Y Nov Y 421 NRHA Youth Jackpot $10 $ AQHA Youth Reining - $45 - AQHA # 5 Y Nov Y 405 AQHA Nov. Youth Reining - $ rd 411 NRHA Rookie- L1 Jackpot $20 $20 NRHA # 6 G NP Y L 412 NRHA Rookie- L2 Jackpot $20 $ AQHA Nov. Am. Reining - $45-6 FOR OFFICE USE ONLY Checks payable to: Attn: Barbara Linke Entry Fee Total Judges Fee Total.. Office fee $25/horse Grounds fee days x $30/day (unstalled).. Video Fee x $5/run.. AQHA Drug Testing $5/horse/judge.. Circuit Stall x $ Day Stall x $60/day... Shavings x $6.50/bag (3.5 cf)/$12/compressed bag (10 cf) $25 $25 $25 Other Entry Form # s TOTAL FOR ONE HORSE FINAL TOTAL= Entries for the first class of the day will close the night before All other classes will close one class prior Show Management reserves the right to interpret these rules All decisions will be final By the way of making an entry, the exhibitor is assuring the responsibility for knowledge of the rules and release show management from any claims or losses The Show Management reserves the right to modify or change show conditions Stalls and Shavings will be paid directly to the Check or Money Order enclosed made payable to or charge to my Visa or MasterCard Credit Card Number Exp. Date Name on Card Signature of Card Holder

4 Pre-Entry Form Texas Classic Working Western Series ROPING ENTRY FORM Complete the form below and FAX or mail with copy of AQHA reg. papers & membership card to: Attn: Melsa Maher 1101 W. Anderson Lane Austin, TX FAX: Responsible Party: Horse Information: (as it appears on AQHA Registration Certificate) Registered Name: Registration No: Year foaled: Sex: S M G Owner Information (as it appears on AQHA Registration Certificate) Owner Name: AQHA ID# Expiration Date: Address: City/State/Zip Exhibitor Information: Open Exhibitor Name: AQHA ID # Exp. Amateur Exhibitor Name: AQHA ID # Exp. Youth Exhibitor Name: AQHA ID# Exp. CLASSES ENTERED: Circle all for one horse; must complete form for each horse entered Entry Fee: $35 per judge (40 % payback) $5 AQHA drug testing fee Breakaway Roping AMA SEL YT Tie-Down Roping JR SR AMA SEL YT Heading JR SR 2220 AMA SEL YT Heeling JR SR AMA 2248 SEL YT

5 Pre-Entry Form Texas Classic Working Western Series BARREL RACING/POLE BENDING Complete the form below and FAX or mail with copy of AQHA reg. papers & membership card to: Attn: Kensey Hayes 1101 W. Anderson Lane Austin, TX FAX: Responsible Party: Horse Information: (as it appears on AQHA Registration Certificate) Registered Name: Registration No: Year foaled: Sex: S M G Owner Information (as it appears on AQHA Registration Certificate) Owner Name: AQHA ID# Expiration Date: Address: City/State/Zip Exhibitor Information: Open Exhibitor Name: AQHA ID # Exp. Amateur Exhibitor Name: AQHA ID # Exp. Youth Exhibitor Name: AQHA ID# Exp. CLASSES ENTERED: Circle all for one horse; must complete form for each horse entered Barrel Racing JR SR AMA SEL YT Pole Bending JR SR AMA SEL 4300 YT Entry Fee: $35 per judge (40 % payback) $5 AQHA drug testing fee per horse/per judge MUST BRING COPY OF AQHA REGISTRATION CERTIFICATE & MEMBERSHIP CARD Upon entering, you hereby release this show, the sponsors, their offices, show management and AQHA from any claim or right for damages to yourself, your employees, horse(s) and equipment. You also accept full responsibility for all show fees incurred by you and your horse(s). Signature:

6 TEXAS CLASSIC WORKING WESTERN SERIES Entry Form for AQHA & NCHA Cutting Classes Deadline for Entries, May 17, 2011 in Office Late Fee for entries received after May 17, 2011 Payment for entry fees and stalls must be included with entry form *Competitors may not enter AQHA Amateur Select and AQHA Amateur class with same horse TUESDAY-May 24 th 8:00 a.m NCHA 4YO Derby $300 Added (EF $271) 717 -NCHA 4YO Derby Non-Pro (EF $271) 718 -NCHA 5/6 YO Classic $300 Added (EF $271) 719 NCHA 5/6 YO Non-Pro $300 Added (EF $271) 700 NCHA Open $400 Added (EF $273) 701 AQHA Senior Cutting/NCHA Open Combined (AQHA only EF $181) NCHA/AQ EF $ NCHA Non-Pro $400 Added (EF $273) 703- NCHA 10,000 Novice Horse $400 Added (EF $273) 704 AQHA Junior Cutting (AQHA only EF $181) NCHA/AQ EF $ AQHA Youth Cutting (EF $161) 705- NCHA Youth Cutting/AQHA Youth Combined (NCHA only EF $143) NCHA/AQH EF $ NCHA 15,000 Novice/Non-Pro $300 Added (EF $253) 708 NCHA 50,000 Amateur $300 Added (EF $253) 709 AQHA Amateur Cutting (AQHA only EF $181) NCHA/AQ Combined EF $ AQHA Amateur Select (AQHA only EF $181) NCHA/AQ Combined EF $ NCHA 3000 Novice Horse $300 Added (EF $253) 712 NCHA 5000 Novice/Non-Pro $300 Added (EF $253) 713 NCHA Non-Pro $300 Added (EF $253) 714 NCHA Amateur (EF $253) 715 NCHA 2000 Limit Rider (EF $253) WEDNESDAY, MAY 25 8:00 a.m NCHA 4YO Derby $300 Added (EF $271) 717 -NCHA 4YO Derby Non-Pro (EF $271) 718 -NCHA 5/6 YO Classic $300 Added (EF $271) 719 NCHA 5/6 YO Non-Pro $300 Added (EF $271) 700 NCHA Open $400 Added (EF $273) 701 AQHA Senior Cutting/NCHA Open Combined (AQHA only EF $181) NCHA/AQ EF $ NCHA Non-Pro $400 Added (EF $273) 703- NCHA 10,000 Novice Horse $400 Added (EF $273) 704 AQHA Junior Cutting (AQHA only EF $181) NCHA/AQ EF $ AQHA Youth Cutting (EF $161) 705- NCHA Youth Cutting/AQHA Youth Combined (NCHA only EF $143) NCHA/AQH EF $ NCHA 15,000 Novice/Non-Pro $300 Added (EF $253) 708 NCHA 50,000 Amateur $300 Added (EF $253)

7 709 AQHA Amateur Cutting (AQHA only EF $181) NCHA/AQ Combined EF $ AQHA Amateur Select (AQHA only EF $181) NCHA/AQ Combined EF $ NCHA 3000 Novice Horse $300 Added (EF $253) 712 NCHA 5000 Novice/Non-Pro $300 Added (EF $253) 713 NCHA Non-Pro $300 Added (EF $253) 714 NCHA Amateur (EF $253) 715 NCHA 2000 Limit Rider (EF $253) ENTRY FORM One Form for Each Horse Copy of horse registration paper and current AQHA and NCHA membership for owner and rider must be included HORSE NAME: RIDER: Rider s NCHA NO. Rider s AQHA NO. Owner Name: NCHA No. AQHA No. Address: City: State: Zip: Telephone: SSN - - TUESDAY, MAY 24: WEDNESDAY, MAY 25: AQHA Drug Fee x $5 per Horse per judge AQHA Drug Fee x $5 per Horse per judge Stall Fee $ Stalls x $185 for circuit Stalls x $ 60 per day Grounds Fee x $30 per day per horse Make checks payable to. Return entry form to Dee McLaughlin, 2201 FM 1810, Jacksboro, TX or by FAX to By making entry into the Texas Classic Working Western Series participant or agent hereby acknowledges that they meet the criteria for eligibility in the classes entered according to the rules and regulations set forth by the AQHA and NCHA. Participant and/or agent understands the risks involved in participation and voluntarily assumes those risks. Participant and/or agent agrees not to hold any sanctioning body, the or Texas Classic or any of its officers, directors or employees, volunteers, clients or fellow participants liable for any injury or property damage arising from or caused at the Texs Classic horse show. Participants and/or agents are solely responsible for reading, understanding and adhering to all applicable rules and regulations. Print name of person making entry: Signature: TOTAL ENTRY FEES TUESDAY$ TOTAL ENTRY FEES WEDNESDAY$ AQHA Drug Testing Fee X $5 per horse per judge Stall Fee $ Total of check enclosed$ Check number: