2015 BREEDERS’ CUP BETTING CHALLENGE Keeneland – Oct 30th & Oct 31st Name: ____________________________________________________________ Street Address: (no PO Box)______________________________________________ City___________________ State_____________________ Mobile: (_____)_________________E-mail: Zip Code________________ ____________________________ Social Security Number: ____________________ Date of Birth _______________ Do you hold a racing license in any jurisdiction? _______ If yes, where? ___________ I plan to participate in the BCBC from (please choose one location): 1. Keeneland 2. Del Mar 3. Gulfstream 4. New York (TBD) it will be either Aqueduct or Belmont Park, not both 5. Santa Anita 6. Las Vegas (site TBD) If you prefer to mail a check instead of paying by credit card at www.breederscup.com/bcbc, complete this entry form and send your deposit check in the amount of no Less than $500 (payable to Keeneland Association, Inc.). Your deposit will be credited towards the total amount due of $10,000. You can later mail a check for the balance which is due by Friday, October 23, 2015. Please send check to: (payable to Keeneland Association, Inc.) Keeneland Association, Inc. 4201 Versailles Road Lexington, KY 40510 Attn: JoAnna-Accounting Please read the 2015 Official Rules prior to sending all entries. All entries must be received no later than Friday, October 23rd. Upon processing/receiving your entry form and credit card/check, you will receive an email confirmation from us. After October 29th, the tournament will be open only if positions are still available. If you have any questions please contact Tim Schram at tschram@breederscup.com or (859) 967-7784, (859) 422-2658.