TRI-COUNTY HORSEMEN SHOW ENTRY FORM

2010 Dates: June 13, July 11, Aug. 1, Sept, 19

Union Fairgrounds – Route 17, Union _ Show Starts at 8:30 a.m.

Entry Fee: $6 per class for members and $8 for non-members received 4 days prior to show. NEHC Medal classis ONLY $5 at all times.

ENTRIES, ADDITIONS OR CHANGES RECEIVED AFTER THURSADAY WILL BE CHARGED $10 PER CLASS except NEHC Medal

NO TELEPHONE ENTRIES ACCEPTED/NO REFUNDS

Please make checks payable to: Tri-County Horsemen ONE RIDER PER ENTRY FORM SHOW DATE:________

Class	#	Horse/Pony Name & Reg # if applicable	Rider’s Name	Rider’s Age	Owner’s name	Owner’s Address	Fee
						Subtotal
						Office Fee per rider $5
		Rider’s Address				Ground fee per animal $3
					Coggin Date:	Number Deposit per rider $1
		Home Phone	E-mail		Rabies Date:	TOTAL DUE

Please, send copies of coggins test and rabies; and send copies of registration for Quarter Horses and Appaloosaa to keep on file.

I herby certify that every horse, rider and handler is eligible as entered and I agree to be bound by the by-laws and rules of the Tri-County Horsemen

and Union Fair Association. I further agree that is any damage or loss occurs to any of the horses or property which I may send to the show, that I will make no claims therefore. I further agree to indemnify and hold harmless the show committee and all the horse show officials Against all claims, demands, suits, and expenses arising out of any injury to any person or animal or to any property caused by myself, my attendant, or my animal.

MAIL ENTRY FORMS TO : Marilyn K. Smith, 152 North Shore Drive, Owls Head, Maine 04854

Signature of Exhibitor__________________________________Signature of Parent or Guardian if a minor_________________________________

Tri-County Use Only: Date Received____________________Paid: Y____N____How_____Owner Member ___Yes__No Rider memeber ___Yes__No