Back#
INDIANA PAINT HORSE CLUB ENTRY FORM/TABSHEET
to be used at July 25-26, 2015 Cloverdale, IN show only
Entered in Computer ____
THIS PRE-ENTRY FORM TO BE USED ONLY FOR JULY 25-26, 2015 SHOW
AT C BAR C EXPO CENTER, CLOVERDALE, IN
Please complete pre-entry form and email to: JWyrick300@ctechinternet.com. Pre-entry form can also be printed
out and completed. Please mail printed form to: Jerry Wyrick, 12336 N 2850 East Rd., Ellsworth, IL 61737
DO NOT SEND A CHECK FOR YOUR PRE-ENTRIES.
This form should not be used to request stalls. Please contact Show Manager Pauli Crull (574) 278-7487 or (574) 870-4686, or
email at crull@pwrtc.com.
Name of Individual Responsible for Payment of Tabsheet
Yes, please email my receipt to me at (email address):
Stalls Reserved Under:
(A) Open Exhibitor
APHA Membership #
City, State
Date of Show
__July 25-26015_______________________
Relationship to Owner
Show Location
__Cloverdale, IN_______________________
(B) Amateur Exhibitor
APHA Membership #
Horse’s Name
Amateur #/Date of Birth
Horse’s APHA #
City, State
Registry:
Year Foaled
Regular
M
Solid Paint Bred
Relationship to Owner
G
(C) Youth Exhibitor
S
Coggins Date:
APHA Membership #
Owner
Youth #
Address
Youth Date of Birth
City, State, ZIP
City, State
Phone
Relationship to Owner
/
Saturday:
Total Amount of All Day Fees From Reverse Side _______ X Number of Judges (__2___)
__________
Total Amount of Class Fees From Reverse Side _______ X Number of Judges (__2___)
__________
APHA Fees - $2 per judge X Number of Judges (_2_)
4.00
Sunday:
Total Amount of All Day Fees From Reverse Side _______ X Number of Judges (__2___)
__________
Total Amount of Class Fees From Reverse Side _______ X Number of Judges (__2___)
__________
APHA Fees - $2 per judge X Number of Judges (_2_)
Number of stalls (____) x Stall fee ($55)
OR
Jumpout Fee (___$15.00____)
Misc Fees (Camping $20/day, Other ____________________)
INPHC Office Fee ($3 per horse/per judge)
4.00
__________
__________
6.00
INPHC Membership (Youth $8, Single $15, Family/Business $25)
__________
Total Amount Due (Paid:
__________
Cash __________
Check# __________)
Name of responsible party:
SAT
Exh
A, B
or C
SUN
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for
all-day fee)
1. Amateur Stallions
2. Amateur Solid Paint Bred Stallions
3. Solid Paint Bred Stallions
4. Yearling Stallions
5. 2 Year Old Stallions
6. 3 Year Old Stallions
Horse Name:
SAT
Exh
A, B
or C
SUN
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for
all-day fee)
40. Solid Paint Bred Yearling Longe Line
41. Open Hunter Under Saddle
(Payback)
42. Walk Trot Hunter Under Saddle
(5-10)
43. Amateur Walk Trot Hunter Under
Saddle (19 & Over)
44. Walk Trot Hunt Seat Equitation
(5-10)
45. Amateur Walk Trot Hunt Seat
Equitation (19 & Over)
SAT
Exh
A, B
or C
SUN
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for
all-day fee)
79. Open Western Pleasure (Payback)
80. Walk Trot Western Pleasure (5-10)
81. Amateur Walk Trot Western
Pleasure
82. Walk Trot Horsemanship (5-10)
83. Amateur Walk Trot Horsemanship
84. Green Western Pleasure
7. Aged Stallions
46. Green Hunter Under Saddle
85. Novice Youth Western Pleasure
8. Youth Geldings
47. Novice Youth Hunter Under Saddle
86. Novice Amateur Western Pleasure
9. Amateur Geldings
10. Youth Solid Paint Bred Geldings
48. Novice Amateur Hunter Under
Saddle
49. Youth Hunter Under Saddle (18 &
Under)
11. Amateur Solid Paint Bred Geldings
50. Amateur Hunter Under Saddle
12. Solid Paint Bred Geldings
51. Junior Hunter Under Saddle
13. Yearling Geldings
14. 2 Year Old Geldings
15. 3 Year Old Geldings
52. Youth Solid Paint Bred Hunter Under
Saddle
53 Amateur Solid Paint Bred Hunter
Under Saddle
54. Solid Paint Bred Hunter Under
Saddle
87. Junior Western Pleasure
88. Youth Western Pleasure (18 &
Under)
89. Amateur Western Pleasure
90. Youth Solid Paint Bred Western
Pleasure
91. Amateur Solid Paint Bred Western
Pleasure
92. Solid Paint Bred Western Pleasure
93. Senior Western Pleasure
16. Aged Geldings
55. Senior Hunter Under Saddle
94. Novice Youth Horsemanship
17. Overo Color
56. Novice Youth Hunt Seat Equitation
95. Novice Amateur Horsemanship
57. Novice Amateur Hunt Seat
Equitation
58. Youth Hunt Seat Equitation (18 &
Under)
96. Youth Western Horsemanship (18 &
Under)
18. Tobiano Color
19. Open Showmanship (Payback)
20. Walk Trot Showmanship (5-10)
59. Amateur Hunt Seat Equitation
21. Amateur Walk-Trot Showmanship
(19 & Over)
60. Youth Solid Paint Bred Hunt Seat
Equitation
61. Amateur Solid Paint Bred Hunt Seat
Equitation
22. Novice Youth Showmanship
97. Amateur Horsemanship
98. Youth Solid Paint Bred
Horsemanship
99. Amateur Solid Paint Bred
Horsemanship
100. Youth Pole Bending (18 & Under)
23. Novice Amateur Showmanship
62, Youth Hunter Hack (18 & Under)
101. Amateur Pole Bending
24. Youth Showmanship (18 & Under)
63. Amateur Hunter Hack
102. Pole Bending
25. Amateur Showmanship
64. Hunter Hack
26. Youth Solid Paint Bred Showmanship
65. Youth Solid Paint Bred Hunter Hack
27. Amateur Solid Paint Bred
Showmanship
66. Solid Paint Bred Hunter Hack
105. Solid Paint Bred Pole Bending
28. Youth Mares
67. Lead Line (3-8)
106. Youth Stake Race (18 & Under)
29. Amateur Mares
68. Walk Trot Trail (5-10)
107. Amateur Stake Race
30. Youth Solid Paint Bred Mares
69. Amateur Walk Trot Trail (19 &
Under)
108. Stake Race
31. Amateur Solid Paint Bred Mares
70. Green Trail
109. Youth Solid Paint Bred Stake
32. Solid Paint Bred Mares
71. Novice Youth Trail
110. Amateur Solid Paint Bred Stake
Race
33. Yearling Mares
72. Novice Amateur Trail
111. Solid Paint Bred Stake Race
34. 2 Year Old Mares
73. Youth Trail (18 & Under)
112. Youth Barrel Racing (18 & Under)
35. 3 Year Old Mares
74. Amateur Trail
113. Amateur Barrel Racing
36. Aged Mares
75. Trail
114. Barrel Racing
37. Amateur Yearling Longe Line
76. Youth Solid Paint Bred Trail
38. Yearling Longe Line
77. Amateur Solid Paint Bred Trail
39. Amateur Solid Paint Bred Yearling
Longe Line
78. Solid Paint Bred Trail
103. Youth Solid Paint Bred Pole
Bending
104. Amateur Solid Paint Bred Pole
Bending
115. Youth Solid Paint Bred Barrel
Racing
116. Amateur Solid Paint Bred Barrel
Racing
117. Solid Paint Bred Barrel Racing