ENTRY FORM FOR HSI SPORT HORSE FOAL CHAMPIONSHIP QUALIFIER 2015 MULLINGAR EQUESTRIAN CENTRE SATURDAY 18TH JULY 2015 ENTRY FEES €40- ENTRIES CLOSE FRIDAY 3RD JULY ENTRIES TO: info@mullingarequestrian.com Region 1: Wicklow, Louth, Kildare, Laois, Offaly, Meath, Westmeath, Dublin Foal Name Registration Number/UELN Colour Sex Studbook Breeder SHOWJUMPING FOAL Owner Name EVENTING FOAL ______________________________________________ (CAPITAL LETTERS PLEASE) Address __________________________________________________________________________________ __________________________________________________________________________________ Mobile Phone No. __________________________________________________________________ Email ___________________________________________________________________________ CREDIT CARD NUMBER CREDIT CARD EXPIRY DATE CREDIT CARD SEC CODE _______________________________________________________ _______________________________________________________ ________ Please charge €40.00 entry fee to my credit card account Region 1- Please Tick box: Wicklow Offaly Meath Westmeath Louth Kildare Laois Dublin Please Note: Foals are only permitted to enter one Regional Championship and must compete in the Region in which the owner resides. For further information on the Championship and other regions that are part of this championship please go to www.horsesportireland.ie Full pedigree and performance details must be provided on the form provided. At the qualifiers, foal pedigrees will be assessed on the basis of the information provided following verification by HSI. HSI will produce a verified catalogue for the final. At least three generations of pedigree should be included. Please give as much detail as possible on relatives’ performance records, additional pages and documents may be included with the application if desired. Details of sire and damsire performance and progeny do not need to be provided if the stallion is classified in the IHR. Page 1 of 2 DOB 1st Dam Name, Breed and Performance Details 1st Dam Progeny Performance Details 2nd Dam (Maternal Granddam) Name, Breed and Performance Details 2nd Dam (Maternal Granddam) Progeny Performance Details 3rd Dam (Maternal Great Granddam) Name, Breed and Performance Details 3rd Dam (Maternal Great Granddam) Progeny Performance Details Sire Name, Breed and Performance Details* Sire Progeny Performance Details* Dam Sire Name, Breed and Performance Details* Dam Sire Progeny Performance Details* *If stallion is not classified in the IHR Page 2 of 2