Form

NCHC Jackpot Entry Form

September 19th-20th , 2026 at the Napan Show Grounds
Name

First NameLast Name
Name of Horse
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Equestrian Insurance Company and Policy Number
Must show proof. Please email copy to northumberlandcountyhorseclub@gmail.com
Age of Competitor
Are you a NCHC member?
If you are not a NCHC member, Please fill out and submit a membership form that can be found on the Facebook page, Northumberland County Horse Club.
Saturday Class List
Sunday Class List
Other Fees
Camping fee
Exhibition Runs Poles Time Slots (max of 2 runs) Friday $5 per run
Exhibition Runs Barrels Time Slots (max of 2) Friday $5 per run
Shavings. $11 per bag.
Total Entry Fees
Payment Method
Signature of Competitor or Parent/Guardian in under the age of 18.
Email for Etransfer is nchorseclub@gmail.com. Please include name and reason for Etransfer in the memo of the transfer. Deadline is September 16th at midnight. Entries after deadline will be subject to $50 late fee. No entries will be accepted after September 18th at 5pm.
Should be Empty:

NCHC Jackpot Entry Form