Futurity/Maturity Entry Form
Race for the Roses May 1-2; Prospector Challenge May 29-30; Madrinas Challenge June 26-27, PEWC Finals October 10-11.
Horse Registered Name
*
Sire
*
Dam
*
Year of Birth (YOB)
*
Dam Sire
*
Sex
Please Select
Stallion
Gelding
Mare
File Upload - copy of registration papers front and back
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Owner Name
*
Breeder Name
*
Rider Name
*
Rider Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Rider Address
*
Rider City
*
Rider State
*
Rider Zip
*
Rider Email
example@example.com
Rider BBR
Entry Details
Option to pay via credit card/debit card or venmo to @Verna-Hultman for futurity/maturity or send payment with event entry form. C/O for Friday/Saturday 1st Open required.
Futurity - Number of Entries
*
Total $250/Horse
Maturity - Number of Entries
Maturity - Total $150/Horse
Payment/Card Information
5% handling fee for credit or debit card payment.
Amount Enclosed (if making payment)
Name on Card
Card Number
Expiration Date
-
Month
-
Day
Year
Date
CSV
Amount to Charge
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