2018 April Entry Form

April 5-8, 2018
Ardmore, OK - Hardy Murphy Coliseum

Cow Horse, Ranch Riding, Reining Special Event

ENTRY FORM MUST BE FILLED OUT COMPLETELY

THIS IS A OKLAHOMA QTR HORSE ASSOCIATION APPROVED SHOW. Join their club if you want to participate in their year-end awards. okqha.com (Forms available at show)

Owner/Rider must be a current member of NRCHA/SRCHA on ALL classes.

AQHA current Membership/Exhibitor ONLY, pay $5 Drug fee per show

Office Fee $35 per back # (Credit of $35 if entry received on or before March 27th)

A COPY OF THE REGISTRATION PAPERS, OWNER/RIDER NRCHA MEMBERSHIP CARDS MUST BE INCLUDED WITH THIS ENTRY. Send to SRCHA c/o Gay Lenz 11587 Hunt Lane, Guthrie, OK 73044. Phone (405) 818-7556 Fax (405) 730-8050 email: entry@srcha.org OR (Just Press SUBMIT)

Make Checks Payable to: SRCHA

Credit Cards Accepted (Master Card & Visa with 5% fee)

You can send payment or pay at the show, however, if you enter and do not attend the event and you DO NOT call and scratch your entry before the draw, you will be responsibile for the entry fee for that horse.

**** Make Checks Payable to Facility for RV & Shavings.

02/05/18

Horse's Name *

Registration Number

Gender

Stallion Mare Gelding

Breed

Sire

Dam

Owner Name *

Last Name, Farm Name, etc First Name (N/A) Middle Name (do not leave blank)

Owner's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Owner's NRCHA #

Exhibitor's Name (Membership Card) *

Last Name First Name Middle Name

Exhibitor's Phone Number *

- Area Code Phone Number

Exhibitor's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Exhibitor's AQHA #

Exhibitor's NRCHA #

Exhibitor's Date of Birth

Month Day Year

Upload Registration Papers, Membership Cards, (Once a Year; unless ownership changes, etc)

Upload a File

pdf, doc, html, zip, mp3, avi, jpg, png etc.

# Ground(s) $25 Per Day

How many?

# Stall(s) $95 (circuit)

How many?

# Day Stall(s) $35 Per Day

How many?

Stalled With

# Herd Practice $90

How many?

# Fence Practice $45

How many?

# Rein Practice $25

How many?

Payee (Social Security Number MUST be on file to receive check) *

OWNER EXHIBITOR

#1 Show Open Bridle Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) IF entering Int. Open Bridle you MUST ENTER Open Bridle

$500 Added (OB) OPEN BRIDLE / Class Fee $55 / Jackpot $85 / NRCHA $8 / Total $148 $50 Added (IOB) INTERMEDIATE OPEN BRIDLE / Class Fee $25 / Jackpot $50 / NRCHA $8 / Total $83 (116200) AQHA Senior Working Cow Horse / Class Fee $60.00 ($25 Discount if entering NRCHA Class) $50 Added (LOB) LIMITED OPEN BRIDLE / Class Fee $40 / Jackpot $65 / NRCHA $8 / Total $113

#2 Show Open Bridle Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) IF entering Int. Open Bridle you MUST ENTER Open Bridle

$500 Added (OB) OPEN BRIDLE / Class Fee $55 / Jackpot $85 / NRCHA $8 / Total $148 $50 Added (IOB) INTERMEDIATE OPEN BRIDLE / Class Fee $25 / Jackpot $50 / NRCHA $8 / Total $83 (116200) AQHA Senior Working Cow Horse / Class Fee $60.00 ($25 Discount if entering NRCHA Class) $50 Added (LOB) LIMITED OPEN BRIDLE / Class Fee $40 / Jackpot $65 / NRCHA $8 / Total $113

#1 Show Open Hackamore Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) IF entering the Int. Open Hack you MUST ENTER Open Hackamore

$250 Added (OH) OPEN HACKAMORE / Class Fee $55 / Jackpot $85 / NRCHA $8 / Total $148 $50 Added (LOH) LIMITED OPEN HACKAMORE / Class Fee $40 / Jackpot $65 / NRCHA $8 / Total $113 $50 Added (SB) SNAFFLE BIT / Class Fee $20 / Jackpot $30 / NRCHA $8 / Total $58 (116100) AQHA Junior Working Cow Horse / Class Fee $60 ($25 Discount if entering NRCHA Class) $50 Added (LOH) INTERMEDIATE OPEN HACKAMORE / Class Fee $25 / Jackpot $50 / NRCHA $8 / Total $83

#2 Show Open Hackamore Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) IF entering the Int. Open Hack you MUST ENTER Open Hackamore

$250 Added (OH) OPEN HACKAMORE / Class Fee $55 / Jackpot $85 / NRCHA $8 / Total $148 $50 Added (LOH) LIMITED OPEN HACKAMORE / Class Fee $40 / Jackpot $65 / NRCHA $8 / Total $113 $50 Added (SB) SNAFFLE BIT / Class Fee $20 / Jackpot $30 / NRCHA $8 / Total $58 (116100) AQHA Junior Working Cow Horse / Class Fee $60 ($25 Discount if entering NRCHA Class) $50 Added (LOH) INTERMEDIATE OPEN HACKAMORE / Class Fee $25 / Jackpot $50 / NRCHA $8 / Total $83

#1 Show Non Pro Bridle Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) NOTE: AQHA Choose Option 1 or 2

$150 Added (NPB) NON PRO BRIDLE / Class Fee $45 / Jackpot $70 / NRCHA $8 / Total $123 $100 Added (INPB) INTERMEDIATE NP BRIDLE / class Fee $30 / Jackpot $45 / NRCHA $8 / Total $83 $50 Added (NNPB) NOVICE NP BRIDLE / Class Fee $30 / Jackpot $45 / NRCHA $8 / Total $83 $65 Added (NPH) NON PRO HACKAMORE / Class Fee $45 / JP $70 / NRCHA $8 / Total $123 $0 Added (NPSEL) NON PRO NRCHA SELECT BRIDLE / Class Fee $30 / Jackpot $25 / NRCHA $8 / Total $48 (216000) (Option #1) AQHA Amateur Working Cow Horse / Class Fee $35 (216800) (Option #2) AQHA Amateur Select Working Cow Horse / Class Fe $35

#2 Show Non Pro Bridle Classes (NRCHA) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) NOTE: AQHA Choose Option 1 or 2

$150 Added (NPB) NON PRO BRIDLE / Class Fee $45 / Jackpot $70 / NRCHA $8 / Total $123 $100 Added (INPB) INTERMEDIATE NP BRIDLE / class Fee $30 / Jackpot $45 / NRCHA $8 / Total $83 $50 Added (NNPB) NON PRO NOVICE BRIDLE / Class Fee $30 / Jackpot $45 / NRCHA $8 / Total $83 $65 Added (NPH) NON PRO HACKAMORE / Class Fee $45 / Jackpot $70 / NRCHA $8 / Total $123 $0 Added (NPSEL) NON PRO NRCHA SELECT BRIDLE / Class Fee $30 / Jackpot $25 / NRCHA $8 / Total $48 (216000) (Option #1) AQHA Amateur Working Cow Horse / Class Fee $35 (216800) (Option #2) AQHA Amateur Select Working Cow Horse / Class Fee $35

#1 Show Non Pro Limited Classes (NRCHA Boxing) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) NOTE: AQHA choose Option 1 or 2

$75 Added (5knpl) $5000 NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93 $75 Added (NPL) NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93 $0 Added (NPLSEL) NRCHA NON PRO SELECT / Class Fee $30 / Jackpot $25 / NRCHA $8 / Total $63 (217000) (option #1) AQHA Amateur Working Cow Horse / Class Fee $35 (217800) (option #2) AQHA Amateur Select Working Cow Horse / Class Fee $35 $75 Added (1knpl) $1000 NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93

#2 Show Non Pro Limited Classes (NRCHA Boxing) Run current - AQHA Classes (Cattle Fee $65 / Video Fee $6) NOTE: AQHA choose Option 1 or 2

$75 Added (5knpl) $5000 NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93 $75 Added (NPL) NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93 $0 Added (NPLSEL) NRCHA NON PRO SELECT / Class Fee $30 / Jackpot $25 / NRCHA $8 / Total $63 (217000) (option #1) AQHA Amateur Working Cow Horse / Class Fee $35 (217800) (option #2) AQHA Amateur Select Working Cow Horse / Class Fee $35 $75 Added (1knpl) $1000 NON PRO LIMITED / Class Fee $30 / Jackpot $55 / NRCHA $8 / Total $93

#1 Show Youth Bridle Classes (NRCHA) Run Current - AQHA Classes (Cattle Fee $65 / Video Fee $6)

$50 Added (YB) YOUTH BRIDLE / Class Fee $25 / Jackpot $40 / NRCHA $8 / Total $73 $0 Added (YB13) NRCHA YOUTH BRIDLE 13-Under / Class Fee $0 / Jackpot $0 / NRCHA $0 / Total $0 (416000) AQHA Youth Working Cow Horse / Class Fee $15

#2 Show Youth Bridle Classes (NRCHA) Run Current - AQHA Classes (Cattle Fee $65 / Video Fee $6)

$50 Added (YB) YOUTH BRIDLE / Class Fee $25 / Jackpot $40 / NRCHA $8 / Total $73 $0 Added (YB13) NRCHA YOUTH BRIDLE 13-Under / Class Fee $0 / Jackpot $0 / NRCHA $0 / Total $0 (416000) AQHA Youth Working Cow Horse / Class Fee $15

HIGH SCHOOL RODEO CLASSES Mark all you want to enter YOU WILL PAY $60.00 PER RUN AND PAY YOUR REGULAR HSR SECRETARY. You pay for your stall and shavings to the SRCHA Show office.

Show 1 Saturday Show 2 Sunday

#1 Show Youth Limited Classes (NRCHA Boxing) Run current - AQHA Classes Cattle Fee $65 / Video Fee $6)

$50 Added (YL) YOUTH LIMITED / Class Fee $25 / Jackpot $40 / NRCHA $8 / Total $73 $0 Added (YL13) NRCHA YOUTH LIMITED 13-under / Class Fee $0 / Jackpot $0 / NRCHA $0 / Total $0 (417000) AQHA Youth Working Cow Horse Boxing / Class Fee $15

#2 Show Youth Limited Classes (NRCHA Boxing) Run current - AQHA Classes Cattle Fee $65 / Video Fee $6)

$50 Added (YL) YOUTH LIMITED / Class Fee $25 / Jackpot $40 / NRCHA $8 / Total $73 $0 Added (YL13) NRCHA YOUTH LIMITED 13-under / Class Fee $0 / Jackpot $0 / NRCHA $0 / Total $0 (417000) AQHA Youth Working Cow Horse Boxing / Class Fee $15

#1 Show Horse Show Classes (NRCHA) (SRCHA) (DO NOT RUN CONCURRENT) Cattle Fee $65 / Video $6

$150 Added (OTR) OPEN TWO REIN / Class Fee $45 / Jackpot $75 / NRCHA $8 / Cattle $65 / Video $6 / Total $199 $50 Added (NPTR) NON PRO TWO REIN / Class $30 / Jackpot $45 / NRCHA $8 / Cattle / $65 / Video $6 / Total $154 $0 Added (GR1) SRCHA GREEN RIDER / Class Fee $20 / Jackpot $0 / Cattle $0 / Video $6 / Total $26 $0 Added (GH) SRCHA GREEN HORSE / Class Fee $20 / Jackpot $30 / Cattle $0 / Video $6 / Total $56 Little Big Shots SRCHA Class Fees $10 No Other Fees

#2 Show Horse Show Classes (NRCHA) (SRCHA) (DO NOT RUN CONCURRENT) Cattle Fee $65 / Video $6

$150 Added (OTR) OPEN TWO REIN / Class Fee $45 / Jackpot $75 / NRCHA $8 / Cattle $65 / Video $6 / Total $199 $50 Added (NPTR) NON PRO TWO REIN / Class $30 / Jackpot $45 / NRCHA $8 / Cattle / $65 / Video $6 / Total $154 $0 Added (GR1) SRCHA GREEN RIDER / Class Fee $20 / Jackpot $0 / Cattle $0 / Video $6 / Total $26 $0 Added (GH) SRCHA GREEN HORSE / Class Fee $20 / Jackpot $30 / Cattle $0 / Video $6 / Total $56 Little Big Shots SRCHA Class Fees $10 No Other Fees

#1 Show Horse Show Classes (AQHA) $30 per class

(134100) AQHA Reining Junior Horse (134200) AQHA Reining Senior Horse (234000) AQHA Reining Amateur (2346) AQHA Reining Amateur Select (434000) AQHA Reining Youth (143000) AQHA Ranch Riding (243000) AQHA Ranch Riding Amateur (243800) AQHA Ranch Riding Amateur Select (443000) AQHA Ranch Riding Youth

#2 Show Horse Show Classes (AQHA) $30 per class

(134100) AQHA Reining Junior Horse (134200) AQHA Reining Senior Horse (234000) AQHA Reining Amateur (2346) AQHA Reining Amateur Select (434000) AQHA Reining Youth (143000) AQHA Ranch Riding (243000) AQHA Ranch Riding Amateur (243800) AQHA Ranch Riding Amateur Select (443000) AQHA Ranch Riding Youth

All Age Herd Only Jackpot Cattle fee

All Age Herd Only Jackpot / Class Fee $60 / Jackpot $30 / Cattle Fee $135 / Video $6 / Total $231

(4/5 year olds) Open Derby - Runs current (50/50 split) Jackpot (Cattle Fee $135 / Video Fee $18)

(OD) Open Derby / Class Fee $125 / Jackpot $125 / NRCHA $8 / $258 (IOD) Intermediate Derby - (Auto Entry if Eligible) / Class Fee $0 / Jackpot $0 / NRCHA $8 / Total $8 (LOD) Limited Open derby - (Auto Entry if Eligible) / Class Fee $0 / Jackpot $0 / NRCHA $8 / Total $8 (NOVH) $5000 Novice Horse Derby - (Do Not Have to enter OD) / Class Fee $75 / Jackpot $75 / NRHCA $8 / Total $158 (L1LOD) Level 1 Limited Open Derby - (Do Not Have to Enter OD) / Class Fee $75 / Jackpot / $75 / NRCHA $8 / Total $158

(4/5 year olds) Non Pro Derby - Runs current (50/50 split) Jackpot (Cattle Fee $135 / Video Ree $18)

(NPD) Non Pro Open Derby / Class Fee $100 / Jackpot $100 / NRCHA $8 / Total $208 (INPD) Non Pro Intermediate Derby - (Auto Entry if Eligible) / Class Fee $0 / Jackpot $0 / NRCHA $8 / Total $8 (NNPD) Non Pro Novice Derby - (Auto Entry if Eligible) / Class Fee $0 / Jackpot $0 / NRCHA $8 / Total $8 (AD)Amateur Derby - (Do Not have to enter NPD) / Class Fee $75 / Jackpot $75 / NRCHA $8 / Total $158 (NPLD) Non Pro Limited Derby (4,5,6 Yr Old Horses) (Boxing) (Do Not Have to enter NPD) / Class Fee $50 / Jackpot $50 / NRCHA $8 / Total $108

Person submitting form - Exhibitor/Agent/Owner/Parent or Guardian, MUST BE 18 or over *

First Name Last Name

Terms and Condtions *

By submitting this form, I hereby acknowledge that I meet the criteria for eligibility to the classes entered according to the guidelines set forth in the NRCHA, AQHA rule book. I understand the risks involved in riding horses and/or cow work and voluntarily assume those risks. I also acknowledge that UNDER OKLAHOMA STATE LAW, OKLAHOMA STATUTES AS SECTION 50.3 OF TITLE 76; AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. I agree that I will not hold NRCHA, AQHA SRCHA, or any of the directors, officers, employees, volunteers, clients, or participants liable for any injury or property damage risking out of or caused by this horse show. I have read this release and understand its terms.

Hold for Check with Credit Card *

YES NO

E-mail *

Contract

Payment information (5% applied)

Name on Card
Credit Card Number
CVS	Exp
Postal / Zip Code	Country

SRCHA Entry Form (All classes) April Show