PRE REGISTRATION

 SHOW:
Please select a show. BCQHA Mini Circuit
* Please select a show.
Responsible Party Name:

 
Email Address:


Phone Number:



HORSE INFORMATION

Breed: AQHA APHA ApHC AHA ABHA IBHA PHBA Other

Horse Name:   AQHA Registration Number:

Year Foaled:         Sex: Stallion Mare Gelding           NRHA Lic.: :

Sire:     Dam:

OWNER INFORMATION:

Name:  AQHA Member ID:  

NSBA Member ID:  NRHA #:  NRCHA #:

Address:  City:  

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    Zip/Postal Code:


EXHIBITOR INFORMATION:

EXHIBITOR 1

AQHA Member ID:  Card Type: Open Amateur Novice Amateur Youth Novice Youth No Card

Name:   Expiration Date:  DOB:

NSBA Member ID:  NRHA #:  NRCHA #:

Address:  City: 

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip/Postal Code: 

EXHIBITOR 2

AQHA Member ID:  Card Type: Open Amateur Novice Amateur Youth Novice Youth No Card

Name:  Expiration Date:  DOB:

NSBA Member ID:  NRHA #:  NRCHA #:

Address:  City: 

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip/Postal Code:

EXHIBITOR 3

AQHA Member ID:  Card Type: Open Amateur Novice Amateur Youth Novice Youth No Card

Name:  Expiration Date:  DOB:

NSBA Member ID:  NRHA #:  NRCHA #:

Address:  City: 

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip/Postal Code:

CLASS SUMMARY

LIST CLASSES YOU WOULD LIKE TO ENTER FOR EACH EXHIBITOR

YOU WILL BE ENTERED FOR ALL DAYS UNLESS OTHERWISE SPECIFIED (INDICATE SO BEHIND CLASS NAME)

THERE WILL BE NO CHARGE FOR CLASSES NOT SHOWN IN

YOU MAY SCRATCH OR ADD ANYTIME PRIOR TO THE CLASS BEING SHOWN

( PLEASE CHECK IN AT THE HORSE SHOW OFFICE UPON YOUR ARRIVAL TO VERIFY YOUR ENTRIES )

 

Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:
Exhib #:   Class #:   Class Name:

TO COMPLETE THE PRE REGISTRATION YOU MUST

FAX (719 384-2052) OR EMAIL ( [email protected] )

A COPY OF REGISTRATION PAPERS AND MEMBERSHIP CARDS

PLEASE INDICATE WHICH SHOW ON YOUR FAX OR EMAIL

I'm Done!
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Send me a carbon copy of this email.