Clone of Summer Sunset Stampede Sunday August 16

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Birth Date

MonthDayYear

Select a Race Session (May enter both sessions)

How many horses are you entering?

If your horse is registered, please use their registered name. If not registered, use their barn name.

Horse #1 Registered Name

Class Selection

Rows	Open	Youth 18 & Under	Adult 19-49	Senior	Senior 60+	Mare	Aged Horse 10+	Up & Coming All Ages	ROTH 9& Under	High Stakes
Entry

Class Selection | Novice Horse Nomination Fee $50 Per Year or $20 Daily Buy In | LTE Enforced

Rows	Green Novice $0-$500	$501-$2500	Non Member Buy If Not Nominated
Entry

Horse #1 Total $

Horse #2 Registered Name

If your horse is registered, please use their registered name. If not registered, use their barn name.

Class Selection

Rows	Open	Youth 18 & Under	Adult 19-49	Seniors 50+	Seniors 60+	Mares	Aged Horses 10 & Over	Up & Coming All Ages	ROTH 8 & Under	High Stakes
Entry

Class Selection | Novice Horse Nomination Fee $50 Per Year 20 Daily Buy In| LTE Enforced

Rows	Green Novice $0-$500	Novice $501-$2500	Non Member Buy In Not Nominated
Entry

Horse #2 Total $

Horse #3 Registered Name

If your horse is registered, please use their registered name. If not registered, use their barn name.

Class Selection

Rows	Open	18U Youth	Adult 19-49	Seniors 50+	Seniors 60+	Mares	Aged Horses 10 & Over	Up & Coming	ROTH 8 & Under	High Stakes
Entry

Class Selection | Novice Horse Nomination Fee $50 Per Year 20 Daily Buy In| LTE Enforced

Rows	Green Novice $0-$500	Novice Horse $501-$2500	One Time Nomination Fee
Entry

Horse #3 Total $

Horse #4 Registered Name

If your horse is registered, please use their registered name. If not registered, use their barn name.

Class Selection

Rows	Open	18U Youth	Adult 19-49	Seniors 50+	Seniors 60+	Mares	Aged Horses 10 & Over	Up & Coming All Ages	ROTH 8 & Under	High Stakes
Entry

Class Selection | Novice Horse Nomination Fee $50 Per Year

Rows	Green Novice $0-$500	Novice $501-$2500	First Time Nomination
Entry

Horse #4 Total $

Horse #5 Registered Name

If your horse is registered, please use their registered name. If not registered, use their barn name.

Class Selection

Rows	Open	Sun Day Money	18U Youth	Adult 19-49	Seniors 50+	Seniors 60+	Mares	Aged Horses 10 & Over	Up & Coming All Ages	ROTH 8 & Under	High Stakes
Entry

Class Selection | Novice Horse - One Time Nomination Fee $50 Per Year

Rows	Green Novice $0-$500	Novice $501-$2500	First Time Nomination
Entry

Horse #5 Total $

Saturday Exhibitions @ 9:00 AM

Exhibitions @ 9:30 AM

Saturday Exhibitions 10:00 AM

Exhibitions @ 10:30 AM

Exhibitions @ 11:00 AM

Exhibitions @ 2:30 PM

Saturday Exhibitions @ 3:00 PM

Saturday Exhibitions @ 4:30 PM

Saturday Exhibitions @ 5:00 PM

Exhibitions @

Total $ Owed ($15 Entry Fee included):

Total $ Owed w/ Credit Card Fee

Please select how you will be paying. Must have a W9 on file to collect winnings.

Payment Amount

USDDescription

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

To make any changes after the form is submitted or to draw out, please text Se'Vette Early at 254-223-1220. We will do our best to assign your run number by the end of the day and will notify you via text.

Comments/Special Requests (Optional)

Visit https://www.irs.gov/pub/irs-pdf/fw9.pdf for a W9 form to fill out and email it to raftereprod@gmail.com!