British Dressage Affiliated Competition Entry Form Name of competition Date Bridle No. (org. use only) Horse Name Owner's Name Horse Registration No. Rider Name Gender Rider Membership No. Age Rider Group Breed Entry 1 Entry 2 Entry 3 Class Section Entry Fee ++ Already Qualified ++ £1.85 of Entry Fee is paid to BD and is not, therefore, subject to VAT Stabling: Straw/Shavings boxes for nights of Eligibility for special prizes: Preferences Address Town/city County Day telephone no. Postcode: Evening telephone no. Total entry fee Stabling fee Total Credit/Debit card details This payment option is only available at certain venues. Please check special notes section in competitions schedule. Full Name: (as printed on your credit card) Credit Card Number: Start Date: Issue number: / Expiry Date: (last 3 digits on signature strip) / I certify that the Owner and Rider are Members of British Dressage and that the Horse/Horses is/are registered with British Dressage. (With the exception of Competitors using the Class Ticket System) I confirm I have read rule 21 (Liability) and I agree to abide by the rules contained in the Official Dressage Rule Book. SIGNATURE: Post Entries to: Entries Secretary, 158 Yarmouth Road, Broome, Bungay, Suffolk NR35 2NZ or enter online via our online entry system on our events page @ www.broadsequestriancentre.co.uk