McCulley Farms May 28,2022
Obstacle Challenge and Poker Ride
Contact McCulley Farms for your Camping/Stall Reservations and Fees
386-938-1147
Rider:
*
First Name
Last Name
Phone Number:
*
-
Area Code
Phone Number
E-mail Address:
*
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age Division:
Youngin' up to 10
Junior 10-18
Adult 18 and up
EQUINE 1
Riding Division: (In hand and under saddle) * Cannot Cross enter divisions with equine. *Can ride another horse in another division.
lead line
walk
walk/trot
walk/trot/canter
Name:
Breed
Age
Coggins Accession Number
Coggins Date
Mare
Gelding
Stallion
Events:
In hand
under saddle
on the trail
all of the above
EQUINE 2 (optional )
Highpoint- Must be the same rider and horse combination
Riding Division: (In hand and under saddle) * Cannot Cross enter divisions with equine. *Can ride another horse in another division.
lead line
walk
walk/trot
walk/trot/canter
Name:
Breed
Age
Coggins Accession Number
Coggins Date
Mare
Gelding
Stallion
Events:
In hand
under saddle
on the trail
all of the above
My Products
prev
next
( X )
Younging/Junior- All 3
$
65.00
Discounted Flat rate for all three (in hand, under saddle, Poker Ride)
Adult- All 3
$
75.00
Discounted Flat rate for all three (in hand, under saddle, and poker ride)
Younging/Junior- IN HAND
$
25.00
Younging/ Junior - UNDER SADDLE
$
25.00
Younging/ Junior - POKER RIDE
$
25.00
Adult- IN HAND
$
30.00
Adult- UNDER SADDLE
$
30.00
ADULT-POKER RIDE
$
30.00
Additional Poker hand
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Lunch Saturday
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Lunch Saturday 10 & under
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
DINNER SATURDAY
$
15.00
Must be prepaid so we can prepare.
Quantity
1
2
3
4
5
6
7
8
9
10
DINNER SATURDAY - 10 AND UNDER
$
10.00
Must be prepaid so we can prepare.
Quantity
1
2
3
4
5
6
7
8
9
10
BARN BINGO
$
Free
Free for all - after dinner in Barn 4 Saturday evening Just need to know if ya plan on coming :)
Family Discount
$
-5.00
Valid for those with 2 or more family members competing. one discount per family member.
Early Entry Discount
$
-5.00
Valid for those entering on or before Wednesday May 18th at 11:59PM
4-H Member Discount
$
-5.00
Valid for Younging/ junior who are active members of the 4-H. In notes: Must state County and Club you are involved in . WE LOVE 4-H !!
Admin Fee
$
15.00
Total
$
0.00
Contact McCulley Farms for your Camping/Stall Reservations and Fees
386-938-1147
Checks: Kaleigh Kozdras 541729 Lem Turner Road Callahan, FL 32011 Zelle: 904-994-8004. PayPal:kayvonnieda@gmail.com
Cash- onsite does not get early discount Fee's.
Paid Via :
*
Check in Mail
Zelle
Cash on site
PayPal
Approximate times you would like to ride: (you do not have to do the events in a particular order. This is to help me get the day running smooth, when you check in at the event you will finalize your ride times.)
Poker Ride
In Hand
Under Saddle
9AM
915AM
930AM
945AM
10AM
1015AM
1030AM
1045AM
11AM
1115AM
1130AM
1PM
115PM
130PM
145PM
2PM
215PM
230PM
245PM
3PM
Notes: (Please include who you would like to be riding with)
Submit Entry
CANCELLATION / REFUND POLICY: No refund for meals. Camping refunds are to go through McCulley Farms Directly. Full refund for Ride entry through Monday May 23rd, 2022 at noon minus $15 admin fee. Full refund through Thursday May 26th, at noon, minus $25 admin fee.
Ride Manager contact information: Kaleigh Kozdras 541729 Lem Turner Road Callahan FL 32011 904-994-8004 kozlandfarm@gmail.com
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform