Winter Breakout Online Entry

Online Entry
Winter BreakOut
January 19-22, 2023
Oregon Horse Center
Eugene, OR

USE ONE ENTRY FORM PER HORSE

Trainer:

Permanent Exhibitor #

Pre-Purchased Only

Name of Horse*

Reg. #*

Year Foaled*

SEX*

Select Registry*

Upload Registration Papers here.

Upload a File

Double Registered Horses Only: Enter secondary breed information

Secondary Breed Registry (2)

Name of Horse (secondary breed only)

If name is different on secondary breed registration.

Secondary Breed Registration # (2)

Secondarty Breed Only

Upload secondary breed registration papers here.

Upload a File

Will this horse be stalled on show grounds?*

YesNo

Is this horse leased?*

YesNo

Upload Lease here.

Upload a File

Horse Owner*

For Leased Horses, enter Lesee as Owner

Mailing Address*

City*

State*

Zip Code*

Phone*

Email Address*

I am aware of and understand that there are inherent risks associated with equine activities. I do hereby consent and agree that the Oregon Quarter Horse Association, American Quarter Horse Association, and/or any cooperative person or group is not liable for an injury to or death of a participant due to the inherent risks associated with these activities and shall not be held responsible for loss, damage and/or liability sustained or suffered while on the show grounds or during participation in this horse show.

As owner/agent I agree to abide by all rules of the association(s) and to pay all costs and fees associated with this entry including but not limited to class entry fees, stall, feed, bedding, association and membership fees. In the event this entry is unsigned, then first entry of this horse into the arena shall be deemed agreement and acceptance of these rules.

OWNER/AGENT*

PARENT/GUARDIAN OF MINOR

Exhibitor #1

NAME *

Upload Exhibitor Membership Cards here.

Upload a File

Type*

BIRTH DATE Required if Yth or Ama

MonthDayYear

Please enter breed ID # and any other applicable ID # for Exhibitor #1.

Relationship to Owner*

Are you related to the owner? If not, Relationship is "None"

ID #*

Select ID Type*

Expiration Date

MonthDayYear

Lifetime

ID # (2)

Select ID Type (2)

Expiration Date (2)

MonthDayYear

Lifetime

ADDRESS if not Owner

City

State

Zip

Same classes both shows? If yes, check here and enter the class numbers in the Thursday/Friday box only.

Yes, same classes both shows

Show 1 Classes:

Enter class number followed by the "enter" key to list classes

Show 2 Classes:

Enter class number followed by the "enter" key to list classes

If your entry is complete, click Submit Form. If not, continue to next exhibitor.

Exhibitor #2

NAME

Upload Exhibitor Membership Cards here.

Upload a File

Type

BIRTH DATE Required if Yth or Ama

MonthDayYear

Relationship to Owner*

Are you related to the owner? If not, Relationship is "None"

Please enter breed ID # and any other applicable ID # for Exhibitor #2.

ID #

Type

Expiration Date

MonthDayYear

Lifetime

ID # (2)

Type (2)

Expiration Date (2)

MonthDayYear

Lifetime

ADDRESS if not owner

City

State

Zip

Same classes both shows? If yes, check here and enter the class numbers in the Thursday/Friday box only.

Yes, same classes both shows

Show 1 Classes:

Enter class number followed by the "enter" key to list classes

Show 2 Classes:

Enter class number followed by the "enter" key to list classes

Message to Show Secretary (optional)

If your entry is complete click Submit Form. If more than 2 exhibitors, use another entry.
Thank you for using online entry! See you at the show!