Official Use Only

HORSE
OR PONY

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BEF
REG

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HEIGHT

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YOB

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RIDER
(list below)

CLASSES ENTERED
List below using class # only

LIST CT DIVISIONS ENTERED BELOW

BDG Membership No.

JUNIOR
DATE OF
BIRTH

AGE AT
01 Sep 09

BEF
Membership
No.

ENTRY
FEE

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 Misc

Administration & Clean Up Fee
Schooling @ $10.00 per round.  Sunday Only

$10
 

 $10.00
 $

Form of payment Cheque or cash  OFFICIAL USE ONLYx

TOTAL AMOUNT  

 $

I hereby state the above information is correct to the best of my knowledge.  I agree that I will not hold the organizers or property owner of lessee responsible for any loss or damage to my horse/pony, my belongings or myself.

Signature - Rider or Agent_____________________________ Date: ________________ Tel: ________________ Fax: ________________