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ICPHA

Class Entry Form

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Please highlight, copy, and paste this entry blank into your word processor in order to print it out.  If you attempt printing directly from the site, you will get this entire page.  Also, in order for the document to fit correctly into your word processor, make sure that the page margins are all set to 0.5".  (This can be done by clicking "File", "Page Setup", and use the arrows to adjust).  I apologize for the difficulty in this task, I'm not sure of any other options.  Thanks.

The following information must be filled out for EACH entry form / for every class you enter.

 

 

CLASS #:

 

BACK NUMBER:

ENTRY FEE $:

PLACING:

 

OFFICE FEE:   $ 3.00  (ONCE PER HORSE/PONY)

TIME:

 

 

NAME OF HORSE/PONY: *________________________________________________________________

 

OWNER: _______________________________  EXHIBITOR: * __________________________________

 

ADDRESS: _______________________________________________________________________________

 

CITY: _______________________ STATE: ________  ZIP: ____________ PHONE (       ) _____________

 

I.C.P.H.A. MEMBER  YES ____   NO ____  * REQUIRED – FULL NAME OF HORSE & EXHIBITOR (AS ENTERED AT THE FIRST SHOW) OR ENTRY WILL NOT BE ELIGIBLE FOR POINTS.

 

In accepting my entry, I hereby release the sponsor(s), their officers, members, and co-sponsor(s) at this show from any claim or right for damages, which may occur to me, my horse(s) or property.  I also assume and accept full responsibility for the above horse at my own risk and agree to abide by the Independent Contest & Pleasure Horse Association rules of the show: All risk or injury to me or horse(s) entered is my own.

 

SIGNATURE: ___________________________________________  DATE: _________________________

 

SIGNATURE OF PARENT IF ENTRY IS UNDER 18 YRS. OF AGE: ______________________________________