Exhibitor Name:
2015 Utah POA ALL-BREED Show
Entry Form Address:
#
Circle age group
Birthday
City, State, Zip code
6 &U 9 &U 10-13 14-18 19 &O
______/_______/______
Phone Number:
Check Gender:
Email address:
Male_____ Female_____
Horse/Pony Name:
Registration #:
Height:
PHC:_____
Circle:
Year Foaled:
Pony Owner:
Mare/Gelding/Stallion
Circle class #’s
1
3
4
5
8
10
11
12
13
16
18
19
20
23
24
25
26
27
28
29
30
31
32
33
34
35
114
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
115
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
116
Select Show:
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
117
 May 16 @ North County Equestrian Park in Highland
 June 27th @ the Wahoo arena in Salem
 August 22th @ Legacy Event Center in Layton
 September 12th @ The Spanish Fork Fairgrounds in Spanish Fork
PRE-ENTERED CLASSES_____X $4
=$__________
LATE ENTERED CLASSES_____X $6
=$__________
UTAH POA MEMBER FEE $5
=$__________
POA NATIONAL FEE $4
=$__________
NON-POA MEMBER FEE
=$__________
TOTAL
=$__________
FOR ENTRIES TO BE CONSIDERED EARLY THEY MUST BE RECEIVED BY
MIDNIGHT THE SUNDAY BEFORE EACH SHOW!
Mail Entries and Payment to:
Utah POAC Show Secretary
Heidi Steeneck
1590 N 300 E
Lehi, UT 84043
For more information contact me at:
utpoacshowsecretary@gmail.com
Make checks payable to Utah POAC
Online Entries Accepted at www.UtahPOA.org
I agree that such entries are made at my own risk and subject to the rules of this show, and of the Pony of the Americas Club, Inc., and I
agree, for myself and my representatives to be bound thereby. I further agree to assume and accept full risk of injury or damage to property
or myself, which may be sustained at the show. I further waive any cause of action that I might or could have by reason of said damages to
myself, my family, or property as against the grounds owner, the POAC, Inc., the host state (Utah POA), or any of the officers, directors, or
members of said associations. I further agree that the show manager has the right to interpret all questions or conditions in regard to dispute
regarding interpretations of the proper color or height to show. No entry fees will be returned except by proper official certificate of illness
of pony or rider by veterinarian or physician. This will serve as my consent of children of minor age to enter this show. I verify that all
information that I have supplied on this form is correct and complete. I have read and understand the show rules and have completed all
necessary designation forms that are required for this entry.
______________________________________________________________________
Signature of rider or authorized guardian if under 18
Date: ________________________________