Regional 4-H Registration

KENTUCKY 4-H REGIONAL & OPEN DRILL TEAM COMPETITION

REGISTRATION FORM
Team Name:*
# of Team Members*
Contact Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Email confirmations will be sent with additional info upon registration receipt
ENTRY FEES: $200 (4 classes) ~ $75 each additional class ~ $75 per class (1-3 classes) ~ $50 Quad Class
Event Classes

Youth NoviceYouth OpenAdult NoviceAdult OpenTheme YouthTheme Adult
4-H Classes

4-H Regional Small Team (1-9 riders)4-H Regional Large Team (10 or more riders)
Quad Classes

Quad NoviceQuad YouthQuad Adult
Entry Fee Total*
# of Gate Passes
1 Free Pass per Rider/Coach
# of Stalls
Qty
X
# of Nights
X $20/night =*
Total Amt for Stalls
Campsite/RV
Qty
X
# of Nights
X $30/night =*
Total Amt for Campsites
Grand Total*
Total Amt for Entry Fees, Stalls, & Campsites
Mail checks or money orders payable to:

Bluegrass Buckshots Equestrian Drill Team

c/o Kara Lovell

2925 State Route 109

Sturgis, KY 42459

Contact info:

Coach Gary Wright

270-952-2551

bluegrassbuckshots@gmail.com

Entry Deadline is September 8, 2017!

(Late Entry Fees = $250 per team (includes 4 classes) or $100 per class ~~ $75 per Quad Class)
Should be Empty: