IHJA B Medal Finals September 10-13, 2026
Horse/Pony Name
Horse/ Pony Size
Horse/ Pony Height
Horse/Pony Color
Horse USHJA Number
Gelding/ Mare/ Stallion
Horse Age
Owner Name
First Name
Last Name
Owner Phone
Format: (000) 000-0000.
Owner USHJA Member ID
Owner Address
Street Address
Endereço (cont.)
City
State
Zip Code
Rider 1 Name
First Name
Last Name
Rider 1 Phone Number
Format: (000) 000-0000.
Rider 1 USHJA Number
Rider 1 Address
Street Address
Endereço (cont.)
City
State
Zip Code
Rider 1 Division Name
Rider 1 Class Numbers
Rider 2 Name
First Name
Last Name
Rider 2 Phone Number
Format: (000) 000-0000.
Rider 2 USHJA Member Number
Rider 2 Address
Street Address
Endereço (cont.)
City
State
Zip Code
Divisions
Classes
Trainer Name
First Name
Last Name
Trainer Phone Number
Format: (000) 000-0000.
Trainer USHJA Member Number
Trainer Address
Street Address
Endereço (cont.)
City
State
Zip Code
Divisions
Classes
Stable Name
Illinois Equine Act: Warning under the Equine Activity Liability Act, each participant who engages in an equine activity expressly assumes the risk of engaging in and legal responsibility for injury, loss, or damage to person or property resulting from the risk of Equine activities.
Rider Print Name
First Name
Last Name
Owner Print Name
First Name
Last Name
Trainer Print Name
First Name
Last Name
Parent/Guardian Print Name (If any Rider is under 18)
First Name
Last Name
Emergency Contact Number (for any Rider under 18)
Format: (000) 000-0000.
Email
example@example.com
Submit
Should be Empty: