Official Entry Form

SOUTH ISLAND WARMBLOOD CHAMPIONSHIP SHOW

Sunday 1st November 2015
Entries Close: Wednesday 28th October 2015 Entries to siwbshow@hotmail.com
or post to SI WB Show, 862 Oxford Road, RD1 Rangiora 7471. Direct deposit using your surname as reference: 01 0141 0050693 02
All enquiries to Michelle Zielazo 0272 540 574, Please call between 5pm & 9pm.
Name Of Horse

Reg #

Sex

DOB

Name of Breeder

Name of Rider

Sire/Dam

Class
No's
Name Of Horse

Reg #

Sex

DOB

Name of Breeder

Name of Rider

Sire/Dam

Class
No's
Name Of Horse

Reg #

Sex

DOB

Name of Breeder

Name of Rider

Sire/Dam

Class
No's
Name Of Horse

Reg #

Sex

DOB

Name of Breeder

Name of Rider

Sire/Dam

Class
No's
Sub Total of Entries:
Admin & Catalogue:
Stables @ $30 each:
Yards @ $15 each:
Ground Fee @ $10 ech

Total of Entries:

$12.00

Entry Fee: - $10 Members (NZWA)

- $15 Non-Members Per Class

Owner/
Exhibitor:

Entries will only be accepted if:

Address:
* Entry is correct & the Admin Fee ($12) is included
Phone No:
* Payment of a ground levy of $10/horse is included
* Full payment of entries is received. Incorrect entries will be Email:
Signature:
returned & may be refused.

Please note that these entries are subject to the conditions regulations of the South Island Warmblood Show. The signing of this Entry Form will deem that the rules conditions of the
show are accepted.