Ingmar de Vos
APPLICATION WILDCARD
FEI WORLD BREEDING JUMPING CHAMPIONSHIPS FOR YOUNG HORSES
FEI ZANGERSHEIDE SIRES OF THE WORLD
23 – 24 – 25 – 26 September 2010
This form must be returned, together with a copy of the paper of origin and the results of the horse, to:
CSI Zangersheide, Domein Zangersheide, B-3620 Lanaken, Belgium or by fax to: +32-89-721913 or mail:
sport@zangersheide.com before: 31 August 2010. Late or incomplete entries will not be accepted!
(Should you wish to enter more than one horse please make copies of this form as we require one entry form per horse.)
Name of horse
: ______________________________ Sex
FEI Passport number : ______________________________ Colour
: Male / Female / Gelding
(delete where not applicable)
: ________________________
Origin - Sire x
Dam's Sire
: ______________________________ Age
: ________________________
Studbook (initials)
: ______________________________ Arrival date : ________________________
Country of birth
:______________________________ Groom
Rider's last name
(and initials)
: ______________________________ Address
: ________________________
(street, postal code & place)
___________________________________________________________________
Country
: ______________________________ Telephone : ________________________
: ________________________
Breeder's last name : ______________________________ Address
: ________________________
(and initials)
(street, postal code & place)
___________________________________________________________________
Country
: ______________________________ Telephone : ________________________
Owner's last name
(and initials)
: ______________________________ Address
: ________________________
(street, postal code & place)
___________________________________________________________________
Country
: ______________________________ Telephone : ________________________
Would like to make a reservation for a table on the VIP-terrace with first-class catering during the day:

4 VIP-tickets (four persons each day)
€ 3.000,- (Excl. VAT)

6 VIP-tickets (six persons each day)
€ 4.500,- (Excl. VAT)
Signature Rider: ____________________
Except in case of cancellation of this application before 11 September 2010, the subscriber commits himself to pay the entry
fee by signing this form, whether he participates or not at the show.