Please tell us what you intend to enter
E vent Date:
Level: Intro, Starter, BN,N
Name.
Division: Horse/Rider/Open :
Address:
City ,State, Zip:
Phone :
Cell phone:
Email. Rider's DOB:
Horse's Name :
Breed: Color: Age: Height:
Name on
Horse Owner:
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Are you riding a 2nd horse: 2nd Horse 's Name and Division :
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H orse Trial: $75 Starter, BN, N ($60 Intro)
HT Level:
HT D ressage Test A or B
HT S tadium Level:
HT X C Level.
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Combined Test: $50
CT Level:
CT D ressage T est A or B:
CT Stadium Height:
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Dressage by itself if not riding HT or CT.
Walk/TrotUSDF Intro A 2007 2010 USEF BN - A 2010 USEF BN - B 2010 USEF N - A 2010 USEF N - B
Name of 1st dressage test .
Name of a dditional dressage test (s) .
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Stadium by itself if not riding HT or CT :
Intro 18"; Starter 2' 0"; Beginner Novice 2' 7"; Novice 2' 11"
1st S tadium. Height.
Add'l round (s) Height.
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Cross Country by itself if not riding HT or CT :
Intro 18"; Starter 2' 0"; Beginner Novice 2' 7"; Novice 2' 11"
1st xc. Level.
A dd'l xc round(s) Level.
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E xtras:
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Entry F ees: Entry Fee for H orse Trial: [$75 ($60 Intro)]
Entry Fee for Combined Test: ($50):
Additional D ressage Tests: ($20 each)
Additional Stadium : ($10 each)
Additional XC : ($20 each)
Entry Fees for individual phases :
1st d ressage if not doing HT or CT($2 5 )
1st stadium round if not doing HT or CT($15)
1st xc round if not doing HT ($35)
T otal:
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Rider's H ighest L evel (past 2 years ) :
Horse's Highest L evel (past 2 years ) :
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Emergency Contact:
Relationship of Emergency Contact:
Phone:
Is your emergency contact accompanying you to Burgundy Hollow? and cell # of someone we may contact d uring the event:
Questions, comments, feedback: