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INDIANA PAINT HORSE CLUB ENTRY FORM/TABSHEET
Entered in Computer ____
to be used at June 13, 2015 Rochester, IN show only
THIS PRE-ENTRY FORM TO BE USED ONLY FOR JUNE 13, 2015 SHOW
AT FULTON COUNTY EQUESTRIAN CENTER, ROCHESTER, 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
__June 13, 2015_______________________
Relationship to Owner
Show Location
__Rochester, 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
/
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 ($30)
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:
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for all-day fee)
Horse Name:
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for all-day fee)
Exh
A, B
or C
$7/class or $40 all-day fee
(Payback classes not eligible for all-day fee)
1. Amateur Stallions
40. Solid Paint Bred Yearling Longe Line
79. Open Western Pleasure (Payback)
2. Amateur Solid Paint Bred Stallions
41. Open Hunter Under Saddle (Payback)
80. Walk Trot Western Pleasure (5-10)
3. Solid Paint Bred Stallions
42. Walk Trot Hunter Under Saddle (5-10)
81. Amateur Walk Trot Western Pleasure
4. Yearling Stallions
43. Amateur Walk Trot Hunter Under Saddle (19 & Over)
82. Walk Trot Horsemanship (5-10)
5. 2 Year Old Stallions
44. Walk Trot Hunt Seat Equitation (5-10)
83. Amateur Walk Trot Horsemanship
6. 3 Year Old Stallions
45. Amateur Walk Trot Hunt Seat Equitation (19 & Over)
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
48. Novice Amateur Hunter Under Saddle
87. Junior Western Pleasure
10. Youth Solid Paint Bred Geldings
49. Youth Hunter Under Saddle (18 & Under)
88. Youth Western Pleasure (18 & Under)
11. Amateur Solid Paint Bred Geldings
50. Amateur Hunter Under Saddle
89. Amateur Western Pleasure
12. Solid Paint Bred Geldings
51. Junior Hunter Under Saddle
90. Youth Solid Paint Bred Western Pleasure
13. Yearling Geldings
52. Youth Solid Paint Bred Hunter Under Saddle
91. Amateur Solid Paint Bred Western Pleasure
14. 2 Year Old Geldings
53 Amateur Solid Paint Bred Hunter Under Saddle
92. Solid Paint Bred Western Pleasure
15. 3 Year Old Geldings
54. Solid Paint Bred Hunter Under Saddle
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
18. Tobiano Color
57. Novice Amateur Hunt Seat Equitation
96. Youth Western Horsemanship (18 & Under)
19. Open Showmanship (Payback)
58. Youth Hunt Seat Equitation (18 & Under)
97. Amateur Horsemanship
20. Walk Trot Showmanship (5-10)
59. Amateur Hunt Seat Equitation
98. Youth Solid Paint Bred Horsemanship
21. Amateur Walk-Trot Showmanship (19 & Over)
60. Youth Solid Paint Bred Hunt Seat Equitation
99. Amateur Solid Paint Bred Horsemanship
22. Novice Youth Showmanship
61. Amateur Solid Paint Bred Hunt Seat Equitation
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
103. Youth Solid Paint Bred Pole Bending
26. Youth Solid Paint Bred Showmanship
65. Youth Solid Paint Bred Hunter Hack
104. Amateur Solid Paint Bred Pole Bending
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
115. Youth Solid Paint Bred Barrel Racing
38. Yearling Longe Line
77. Amateur Solid Paint Bred Trail
116. Amateur Solid Paint Bred Barrel Racing
39. Amateur Solid Paint Bred Yearling Longe Line
78. Solid Paint Bred Trail
117. Solid Paint Bred Barrel Racing