Henry County Saddle Club Entry Form

Entry Form
Mare
x if mare
Gelding
x if gelding
Stallion
x if stallion
Email
Email address that we can contact you (signee of this form)
BACK #
Request back number or we will assign
of stalls
List number of stalls using
Stalled with
List self or trainer
#Camping Nights
Camping is $35 / night PRE-PAY BEFORE ARRIVAL. Put 0 if not camping. Pay here https://app.autobooks.co/pay/hc-saddle-club
Horses Name
Type Exactly as on Registration
Year Horse Born

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Horse AQHA Registration #
Horse NSBA L#
Owner of Horse
Type exactly as it is on your AQHA Card.
Owner AQHA #
AQHA Card Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owners NSBA#
Type exactly as it appears on your card
NSBA Card Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
YOUTH / Small Fry
Youth/Sm Fry Name ~
Type exactly as on your card
Birth Date of Youth-Required

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
AQHA Card #
AQHA Card Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Youth NSBA #
NSBA Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship to owner
Add Class Numbers Here
List class #'s here. List class numbers twice if entering Friday and other days. Example: 1,1
AMATEUR Information
Amateur Exhibitors Name ~
Type exactly as it appears on your card
AM Exhibitor Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
AM Exhibitor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
AM Exhibitor AQHA Card#
AM Exhibitor AQHA Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
AM Exhibitor NSBA#
AM Exhibitor NSBA Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship to owner
AM Add Class Numbers Here
List class #'s here. List class numbers twice if entering Friday and other days. Example: 1,1
Open#1 Exhibitors Name
Open Exhibitor Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open Exhibitor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Open AQHA Card#
AQHA Card Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open NSBA #
NSBA Card Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open #1 Class# Entry
List class #'s here. List class numbers twice if entering Friday and other days. Example: 1,1
Open #2 Exhibitors Name
Open #2 Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open #2 Exhibitor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Open #2 Exhibitor AQHA Card#
Open#2 Exhibitor AQHA Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open Exhibitor#2 NSBA#
Open#2 Exhibitor AQHA Exp Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Open #2 Class# Entry
List class #'s here. List class numbers twice if entering Friday and other days. Example: 1,1
SIGNATURE OF PARTICIPANT or Parent/Guardian if Minor
Date of Signature

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
CELL PHONE of participant AT THE SHOW: In the event we have a question on your entries.
Format: (000) 000-0000.
We do NOT charge for scratches - please enter everything & scratch as needed. You must show in your respective halter class to qualify for the high point awards. Mail copy of entry form, horse registration, AQHA and NSBA and open check made out to HCSC (if you showed at Indy Circuit mail check only if no changes) to:

HCSC, P.O. Box 5, New Castle, IN 47362

Please send a check for camping separate which is required to be pre-paid before arrival or pay here: https://app.autobooks.co/pay/hc-saddle-club
Henry County Saddle Club (HCSC), Henry County, Memorial Park, Indiana Quarter Horse (IQHA) American Quarter Horse Association(AQHA) its owners, its employees, its agents, and its guests will not be held responsible for accidents or loss which may occur to an exhibitor, spectator, guest, rider, groom, other employee, animal, or equipment; nor will they be responsible for any article of any kind or nature that may be lost, destroyed, or stolen, whether or not such loss, damage, or injury is the result of HCSC, AQHA, NSBA, or their employees or their independent contractors. All exhibitors, spectators, guests, riders, grooms, or other employees are subject to the rules and regulations of AQHA, IQHA and HCSC. HCSC, IQHA, NSBA and AQHA, may use or assign photographs, videos, audios, cable - casts, broadcasts, internet, film, new media, or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. WARNING: Under Indiana law, an equine activity sponsor or equine professional is not liable for injury to, or death of, participant in equine activities resulting from the inherent risks of equine activities.
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