Crystal Crown JPR

Name of Rider

First NameLast Name
Rider's Age
As of ride date. Rider's age is used for age division placings and ribbons
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Horse's Name
Use Registered Name if applicable
Registered Breed of Horse
Must provide a copy of breed registration papers below if competeing for end-of-year points in your specific breed catagory. If unregistered leave blank
Upload Breed Registration Papers

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Gaited

YESNO
Novice Rider

YES-Novice RiderNO- Not Novice Rider
Novice Horse

YES- Novice HorseNO- Not Novice Horse
Lunch Preference-includes soda or water and chips. Additional lunches may be purchased at check out.

Vegetarian SandwichHam & Cheese SandwichTurkey Sandwich
Coggins Upload*

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I have read and understand Alanwood Farm's EQUINE ACTIVITY LIABILITY RELEASE, WAIVER OF RIGHT TO SUE AND ASSUMPTION OF ALL RISKS*
Signature*

Clear
I wish to ride with the following people.

First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
Preferred Start Time (assigned on first come-first served basis. Not guaranteed)

9:30-10:3010:30-11:3011:30-12:30Anytime is fine
Check Out
prevnext( X )
Pre-Registration ** Ends Monday June 19th**Lunch is included
$65.00

Guest LunchLunch Includes Water or soda and chips
$10.00 Quantity

Total

$0.00
If paying with credit or debit card click either PayPal or Venmo and you will see the Credit/Debit card option

Payment Methods

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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