I Mail entries to:

'
Lenard Davenport
231 S. James River Landing
i
*ixa' MO 65714
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October 11-121 2014
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8802 Hwv M - Mt. Vernon, MO 657 12
!
orn.e use only
I Account
Group/Trainer
EIA
D
!ABCD IABCD
OpeniAmateur Classes
@
$ 35.00 $-
Youth Classes
@
s 2s.oo $--
Flat Class Fee
@
5100.00 $
One anirnal tbr pre-entered classes only.
Stall/Tack Stall l0'xl0'
@
$ 45.00 s--
Fri. noon to Mon. noon. Two animal max. per stall.
One animal
Der form,
ff.
i* i F istered Name of Horse/Pon
;# Re
I iI-
lli
Class Number Entered one class
D
I AB
It{o barn or stable names.
Handler/Driver Name
('
A')
Signature (Parent/Guardian if Junior Exhibito$ X
HandlerlDriver Name'c B')
Signature (Parent/Guardian if Junior Exhibitor) X
Handler/Driver Name
cL
C'
Signature (Parent/Guardian if Junior Exhibitot)
X
Handler/Driver Name 'c Il"
Signature
(ParenVGuardian if Junior Exhibitor) X
OWNER(SI (ut appear on registration certificate)
Name
Age- No--
Bags of Shavings
@
$ 8.00 $
Must order from Flying M & pay in advance.
Tie-out Fee
Age- No-
Per animal/Per day. No overnight tie-out allowed.
Office Fee per animal
@
$ 8.00 $_--
Late Entry Fee per animal@ $ 2S.00 $-
For entries made day of show' plus regular class fees.
RV/Trailer Hook-up
@
$ 20.00 $--
Per day for water & electric
Total Enclosed $
Make checks payable to: Equine Ventures Unltd.
Credit Card No
MC visaDisc. Exp.date_ l-J-Security Code-
Name on Card
Office use Onlv.
Name
Check #
Check #
Check #
Circle A.B.C
ABCD
;ABCD
Youth Amateur/Youth
No Age
Age No
Phone
Address
Member No
City, State, Zip
E-mail
TRAINER (person with care, custody & control of animal, not necessarily a professional)
Name
Phone
Address
Member No
City, State, Zip
E-mail
t
r
t
i
I
t
I
I
J
Name $_
l
:
a
STATEMENT OF RESPONSIBILITY AND LIABILITY
This show is approved by ASpC/AMHR. AII entries must comply with the rules of the current ASPC/AMHR rule book or publication. By entering this event, I hereby
agree to abide and be bound by all the ASpC/AMHR rules and regulations. I also agree to hold harmless Equine Ventures Unltd., LLC and Flying M Enterprises, LLC,
iti o*n"rs, directors and employees, from all liability and all claims, demands, cause ofaction, costs, charges, and expense ofevery kind and nature arising out ofor
which may be incuned by reason ofany accident, thlft, iniuries, loss or damages ofany kind either to myselfor all persons witlr me, property, or to any animal in my
ownership, care, custody or control in any way associated with my participation in this event. Presentation of signed entry blanks shall be deemed acceptance of these
rules and in the event oifailure to sigr thl entry blank, the first entry into the show ring as an exhibitor shall be deemed to be the acceptance ofrules'
i
I Please stable with
I
I
X
Signature of Owner
X
Date
i
Note: All exhibitors who wish to be stabled together
I
fVfUSf send their entries together in the same envelope.
Date
t
I
Signature of Trainer
Parent or Guardian must sign both places for Youth
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