CPHC SUMMER SIZZLER POR

CAROLINA SPRING COLOR CLASSIC

August 5-6, 2023 Lumberton, NC
Responsible Party
Responsible Party - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Back Number (Preferred)
HORSE INFORMATION - APHA OR ALL BREED
REGISTRATION #
FOAL DATE

MonthDayYear
Date
MareStallionGelding
Horse Registered Name (EXACTLY as shown on reg. papers)
Horse Owner (EXACTLY as shown on reg. papers)
Owner APHA #
Owner APHA # Expiration Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Leasee (EXACTLY as shown on reg. papers) - if applicable
(EXACTLY as shown on reg. papers)
Leasee APHA # - if applicable
Leasee APHA # Expiration - if applicable
Exhibitor Info
Exhibitor 1 Name (EXACTLY as shown on card)
Exhibitor 1 DOB
APHA ID #:
APHA ID # Exp. Date

MonthDayYear
Date
AmateurYouthNoviceWalk/TrotOpenAll Breed
Am/Youth/Walk Trot/Novice Card Expiration Date

MonthDayYear
Date
Exhibitor 1 Relationship to Owner
Exhibitor 1 Classes
EXHIBITOR 2:
Exhibitor 2 Name (EXACTLY as shown on papers)
Exhibitor 2 DOB
Exhibitor 2 APHA ID #:
Exhibitor 2 APHA # Expiration Date

MonthDayYear
Date
AmateurYouthNoviceWalk/TrotOpenAll Breed
Am/Youth/Novice/Walk Trot Expiration Date

MonthDayYear
Date
Exhibitor 2 Relationship to Owner
Exhibitor 2 Classes
Accommodations Information
Horse Stalled With:
# Stalls @ $85/each
# SHAVINGS @ $8.00/Bag
RV NIGHTS @ $40/Night
HAUL IN @ $15/Day
Under North Carolina Law, an equine professional is not liable for an injury to or death of a participant in equine activities resulting from the inherent risk of equine activities, Chapter 99E of the North Carolina Statutes.

By signing this form, hereby release CPHC, APHA, Southeastern Ag Center, & Emma Rhodes (Show Secretary) from responsibility of any loss, theft, injury. or death that may occur at this show.
SIGNATURE
DATE

MonthDayYear
Date
Should be Empty:

CAROLINA SPRING COLOR CLASSIC

HORSE INFORMATION - APHA OR ALL BREED

Exhibitor Info

EXHIBITOR 2:

Accommodations Information