2015 CUMBERLAND FAIR - 4-H HORSE SHOW Number ENTRY FORM Exhibitor's Name Address Phone Number: Exhibitor's Age Walk-Trot Jr. Sr. Horse's Name No cross entries for riders allowed between the walk / trot and walk / trot / canter divisions. Owned By Club Classes Entered: , , , , , , , , , , , , , , , . Signature of Parent or Guardian: NOTE: Please enclose a copy of your current Coggins Test and bring a copy with you the day of the 4-H horse show. Please bring a Certificate of Vaccination for Equine Herpes Virus, Type 1 (EHV-1) & Equine influenza Mail to: Mark Cooper 81 Chute Road Windham, ME 04062 Please submit entries by September 1st 4-H members are invited to ride in the parade (Saturday, October 3rd) if they would like. PLEASE PLAY IT SAFE AND HAVE YOUR ANIMAL VACCINATED FOR RABIES.