Electronic Entry for MTSPHA April 16, 2011 Show
Filling out this form does NOT hold you financially responsible for any fees if you cannot attend the show.
Please call Jo Long if you submit an entry and cannot attend. (918) 938-1045
Pinto Horse Information
Horse Name PtHA Registration #
Mare Gelding Stallion Foaling Date: Pattern: Solid Overo Tobiano Tovero Type Select Stock Saddle Hunter Pleasure Pony Mini A Mini B All Breed
All Breed Horse Information
Horse Name Mare Gelding Stallion
Exhibitor Name
Owner Information
Owner Name Owner PtHA ID #
Owner Address City State Zip
Owner Email Address
Youth Exhibitor Information
Youth Name Youth PtHA ID # Is This a Novice Card Select Yes No
Youth Address City State Zip
Youth Birthday (mmddyyyy) Youth relationship to Owner:
Is address same as Owner? Select Yes No
Amateur Exhibitor Information
Amateur Name Amateur PtHA ID #
Is address same as Owner? Select Yes No Is This a Novice Card Select Yes No
Amateur Address City State Zip
Amateur relationship to Owner:
Open Exhibitor Information
Name PtHA ID #
Address City State Zip
Please put a check mark by the class you wish to show in.
OAB=Open All Breed
All Horses MUST be stalled, How many stalls do you need? 1 2 3 4 5 6 7 8 9 10 Is one of these a tack stall? Select Yes No
Comments: (are you with a group and want to stall with them, do you like this form, feedback for club, etc...)
In consideration of the acceptance of any entry, the owner, trainer, exhibitor, hereby releases and agrees to hold harmless the show management, staff,
or facility from any liability for loss or damages, if any, suffered or sustained by owner, trainer, exhibitor or such entries as a result of personal injury or property
with little or no participation. (Parent or guardian must electronically sign for exhibitors under 18 years of age.)
Electronic Signature of Exhibitor, Parent, or Guardian
Date: