NCRHA Kirkwood Summer Show
July 4-5, 2026 Kirkwood IA
ONE FORM PER HORSE
Once you submit your entry you will receive an email confirmation.
Horse Information
Horse Name
*
Year Foaled
*
Breed
*
AQHA
APHA
Other
Breed Registration Number
*
NRHA License Number
*
Horse Competition License
Browse Files
Cancel
of
Responsible Party
Person Responsible for this Horse's Show Tab
*
Conformation Email
*
Send Payout To:
*
Owner
Rider
Owner Information
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Owner NRHA Membership #
*
Type of Membership
Open
Non Pro
Youth
Owner NRHA Membership Card
Browse Files
Cancel
of
NRHA Membership Exp
/
Month
/
Day
Year
Date
Youth Rider Date of Birth
/
Month
/
Day
Year
Date
Owner Breed Membership #
Is Rider same as Owner
*
Yes
No
Rider 1 Information
Please complete only if RIDER 1 is different from OWNER. Thank you
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Rider 1 NRHA Membership #
Type of Membership
Open
Non Pro
Youth
Rider 1 NRHA Card
Browse Files
Cancel
of
NRHA Membership Exp
/
Month
/
Day
Year
Date
Rider 1 Breed Membership #
Rider 2 Information
Please complete only if the horse is being shown by multiple riders.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Rider 2 NRHA Memerbship #
Type of Membership
Open
Non Pro
Youth
Rider 2 NRHA Card
Browse Files
Cancel
of
Rider 2 NRHA Membership Exp
-
Month
-
Day
Year
Date
Rider 2 Breed Membership
Class Entries
Class / Entry / Judge / Office
Saturday's Classes
1 Rookie Pro $20/$10/$15
2 Ltd Open $25/$15/$15
3 Rookie L1 $20/$10/$15
4 Rookie L2 $20/$10/$15
5 PT Rookie $20/$10/$15
6 Youth 13 & Under $10
7 Youth 14-18 $10
8 Youth 10 & Under $10
9 Novice Open L1 $25/$15/$15
10 Novice Open L2 $50/$25/$15
11 Novice Open L3 $50/$25/$15
12 Green Reiner L1 $25/$15
13 Green Reiner L2 $25/$15
14 Non Pro $100/$50/$15
15 Int Non Pro $50/$25/$15
17 Limited Non Pro $20/$10/$15
18 Non Pro Derby L4 $150/$75/$15
19 Non Pro Derby L1 $75/$35/$15
20 Non Pro Red Shirt Derby $100/$50/$15
Sunday's Classes
21 Open $100/$50/$15
22 Int Open $50/$25/$15
23 Ltd Open $25/$15/$15
24 Rookie Pro $20/$10/$15
25 Open Derby L4 $200/$100/$15
26 Open Derby L1 $100/$50/$15
27 Open Red Shirt Derby $100/$50/$15
28 Green Reiner L1 $25/$15
29 Green Reiner L2 $25/$15
30 Ltd Non Pro $50/$25/$15
31 Masters Non Pro $50/$25/$15
32 Youth 13 & Under $10
33 Youth 14-18 $10
34 Youth 10 & Under $10
35 Rookie L1 $20/$10/$15
36 Rookie L2 $20/$10/$15
37 PT Rookie $20/$10/$15
38 Novice Non Pro L1 $25/$15/$15
39 Novice Non Pro L2 $50/$25/$15
40 Novice Non Pro L3 $50/$25/$15
Additional Fees (Per Horse Per Show)
NRHA Drug Fee $10 Video Fee $15
Questions please contact Connie at (402) 741-1660 or whitehorsemgt@cccusa.net
SUBMIT
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