2023 District #6 IQHA Entry Form

District #6 IQHA Show

ENTRY FORM

May 27-29th, 2023

Crawford County Fairgrounds

Denison, IA

Date

HORSE INFORMATION

Horse Name*

AQHA Registration #*

Year Foaled*

Sex*

Trainer Name:

OWNER INFORMATION

Owner Name:*

(For Leased horses, enter Lessee as Owner Name)

Owner AQHA Number:

AQHA Exp. Date:

MM/DD/YYYY

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Email*

example@example.com

Phone Number*

Format: (000) 000-0000.

EXHIBITOR #1 INFORMATION

YesNo

Exhibitor #1 Name*

Date of Birth:

MM/DD/YYYY

Relationship to Owner:

Yth. & Amt. must have valid relationship / Open=None

AQHA #:

AQHA Exp. Date:

MM/DD/YYYY

AQHA Membership Type:

Address if different from Owner

Street Address

Street Address Line 2

CityState

Zip Code

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Enter the Class #'s you wish to enter for Exhibitor #1:

(Example: 10, 13, 19)

EXHIBITOR #2 INFORMATION

Exhibitor #2 Name

Date of Birth:

MM/DD/YYYY

Relationship to Owner:

Yth. & Amt. must have valid relationship / Open=None

AQHA #:

AQHA Exp. Date:

MM/DD/YYYY

AQHA Membership Type:

Address if different from Owner

Street Address

Street Address Line 2

CityState

Zip Code

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Enter the Class #'s you wish to enter for Exhibitor #2:

(Example: 10, 13, 19)

Submit Horse Papers & Owner/Exhibitor AQHA Membership Cards here:

Using a computer? Please use "Browse Files" button to attach documents.

Browse Files

Using a Tablet or Phone? Please use "Take Photo" button to take a picture.

Notes for Show Secretary:

DISCLAIMER OF LIABILITY AND AGREEMENT

I accept any and all liability for any accident, loss, damage, injury or illness to any riders, horses, owners, spectators, property, vehicles and their contents and accessories or any other person or property whatsoever, whether caused by their negligence, breach of contract or in any other way whatsoever. Horses are entered at my own risk and are subject to AQHA & IQHA rules. In case of death, accident, injury or theft, to the exhibitor, their friends & family, horses, property, etc., no claims will be honored against Crawford County Fairgrounds, Iowa Quarter Horse, Show Management or Staff and all those associated with this show.

By signing below, I agree to these conditions.

Participant Signature (Parent or Legal Guardian must sign for minor exhibitors. Must be 18 to sign):

Click Submit to complete your entry.
Click Print Form for your records or to print & mail.

Use your mouse or finger to sign here:

If you are printing this form, click the "Print Form" button above and mail to:

Fox Show Services

District #6 IQHA Show

PO Box 88

Oxford, IA 52322