Official Entry Form South Island Warmblood Championship Show Saturday 5th November 2011

Entries Close on: Fri 21st Oct 2011: with Show Secretary, Selena Hack, 59 Te Pouapatuki Road, RD 1, Kaiapoi 7691

NO TELEPHONE ENTRIES WILL BE ACCEPTED

PLEASE MAKE THE FOLLOWING ENTRIES SUBJECT TO THE CONDITIONS AND REGULATIONS OF THE SOUTH ISLAND WARMBLOOD SHOW
Class Entry Fee Name of Horse Horse Reg # Sex Date of Birth Name of Breeder Name of Rider (If applicable) Pedigree

Sub Total of Entries Admin & Catalogue

Stables $25 ea Yards $ 10 ea Ground fee $10/horse Late fee if after 31 Oct 2012 $10/horse Total of Entries

Sire : Dam Sire : Dam Sire : Dam: Sire: Dam: Sire : Dam: Sire: Dam: Sire: Dam: Sire: Dam: Sire: Dam: Owner / Exhibitor : $6.00 ENTRY FEE: $8.00 MEMBERS (NZWHA) : $12 NON-MEMBERS - PER CLASS PLEASE LEAVE STABLES & YARDS CLEAN ENTRIES WILL ONLY BE ACCEPTED IF : Entry is Correct Admin & Catalogue $6.00 Payment of Ground Levy $10.00 per horse Full Payment of Entry IF ENTRY IS NOT RECEIVED CORRECT IT WILL BE RETURNED Please make all cheques payable to: Phone : Email : Address : Signature : The signing of this Entry Form will deem that the rules & conditions of the Show are accepted Please tick the Box if you DO NOT wish to receive next years schedule by email

South Island Warmblood Show

Entry Form 11.doc