TRI STAKES
Slot Purchase Form
Slot owner name (can be a business)
Slot Owner Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Rider Name
Rider Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is Rider address the same as slot owner address. If so, skip the address info below.
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Horse Registered Name
Owner of Registered horse
Please upload registration papers of horse placed in slot.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Is horse eligible for Gridiron Breeders' Incentive?
Please Select
Yes
No
Is horse eligible for Lucky 7 Bonus?
Please Select
Yes
No
Has slot owner ever been a member of Northern Futurity Finale?
Please Select
Yes
No
prev
next
( X )
Tri Stakes Slot
One slot in Tri Stakes
$500.00
$
500.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
Should be Empty: