LBHA Horse Show 2022

LBHA Horse Show Entry
PLEASE READ:
- One form per show and rider. Multiple horses okay.
- Each horse & rider combo get a horse show # written on gate pass.
- One gate pass per class. Choose/estimate the classes you want to go in and purchase the amount of gate passes needed.
- Unused Gate Passes are non-refundable.
Which Show are you attending? One form per show please *

English Saturday Oct 8, 2021 Western Sunday Oct 9, 2021
Rider Name *

First Name Last Name
Age if under 18:
*HELMET REQUIRED for Juniors 17 & under in ALL ENGLISH and WESTERN classes
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com

Horse(s) being shown by this rider. *

Affidavit: I hereby certify that the above named horse(s)/rider are eligible as entered. I agree to hold harmless the Loomis Basin Horsemen's Association, Placer County, and those connected with the horse show, against any claim for injury to myself, my horse, or my property, whether or not such claim might be based on negligence. I agree to the form of this contract including the indemnity provisions there in. I understand there is a $20 charge for returned checks. HELMETS REQUIRED for all youths 18 and under in Western & English classes.
Rider or Parent/Guardian Signature (Use computer mouse or finger) *

Clear
Name of signor if different than rider

First Name Last Name
Date

Month Day Year
Date
Purchase gate passes, can buy more day of show.
prev next ( X )
1 Gate Pass = 1 Class Passes are for Western or English day only and cannot be combined
$ 5.00 Quantity
Item subtotal: $ 0.00

LBHA Donation Choose quantity in increments of $5
$ 5.00 Quantity

Traylor Ranch Nature Preserve Donation Choose quantity in increments of $5
$ 5.00 Quantity

Total

$ 0.00

Payment Methods

Debit or Credit Card

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

LBHA Horse Show Entry