ADDED
MONEY
CLASS
#
CLASS STRUCTURE
Entry Fee
Key In Entry
Fee to Enter
GO
ROUNDS
FINALS
70,000$ 1 4 YEAR OPEN 2,000$ 2 YES
OWNER:
7,500$ 2 4 YEAR OPEN 10K Novice Horse (LTE) 1,100$ 1 YES
3 4 YEAR OPEN GELDING 500$ CWC PENCIL
7,500$ 4
4 YEAR OPEN LIMITED 200K (*2yr RB)
1,100$ 1 YES
NCHA:
SS# :
2,000$ 5
4 YEAR OPEN LIMITED 200K 10K Novice (*2yr RB)
700$ 1 YES
6
4 YEAR OPEN LIMITED GELDING 200K (*2yr RB)
500$ CWC PENCIL
10,000$ 7 4 YEAR NON PRO 1,200$ 2 YES
ADDRESS:
8 4 YEAR NON PRO SENIOR 500$ CWC PENCIL
9 4 YEAR NON PRO GELDING 500$ CWC PENCIL
10 4 YEAR NON PRO 10K NOVICE (LTE) 500$ CWC PENCIL
STATE:
ZIP
CELL:
2,000$ 15
4 YEAR NON PRO LIMITED 50K (*2yr RB)
700$ 1 YES
16
4 YEAR NON PRO LIMITED SENIOR 50K (*2yr RB)
300$ CWC PENCIL
17
4 YEAR NON PRO LIMITED GELDING 50K (*2yr RB)
300$ CWC PENCIL
18
4 YEAR NON PRO LIMITED 10K NOV 50K (*2yr RB)
300$ CWC PENCIL
EMAIL ADDRESS:
5,000$ 19 4 YEAR AMATEUR (TOP LEVEL) 900$ 1 YES
20 4 YEAR AMATEUR (TOP LEVEL)SENIOR 300$ CWC PENCIL
HORSE:
21 4 YEAR AMATEUR (TOP LEVEL) GELDING 300$ CWC PENCIL
3,000$ 22 4 YR INTERMEDIATE AMATEUR check if Combo 800$ 1 YES
23 4 YEAR INT AMATEUR SENIOR 300$ CWC PENCIL
REG:
24 4 YEAR INT AMATEUR GELDING 300$ CWC PENCIL
1,000$ 25 4 YEAR LIMITED AMATEUR check if Combo 600$ 1 YES
26 4 YEAR LIMITED AMATEUR SENIOR 300$ CWC PENCIL
RIDER:
27 4 YEAR LIMITED AMATEUR GELDING 300$ CWC PENCIL
Amateur ONLY Comb Fee Deducted @ $100 per combo
____ x 100
(Ex: 2 x $150 = $300) STALL FEE $150. EACH
____ x 150
NCHA:
MAIL TO:
E-MAIL:
FAX:
Print completed entry form, then fax to 405-701-6726 or mail.
NOTE: YOU MUST SEND IN THIS ENTRY FORM AS INSTRUCTED ABOVE TO ENTRY.
You can also SAVE this entry form and email to hillermandella@aol.com.
TOTAL ENTRY FEE DUE
THE IKE , 22522 HWY 102, TECUMSEH OK. 74873
TOTAL OF CHECK #
* 2 Yr Roll Back (No Hall of Fame Riders) 405-701-6726 TELE: 405-598-2568
CREDIT CARDS ACCEPTED WITH A 4% CONVENIENCE FEE ADDED.
THE IKE DERBY AND CLASSIC
IKE HAMILTON ARENA, WEST MONROE, LA.
4 YEAR OLD ENTRY FORM
DELLA HILLERMAN, SCRETARY 405-598-2568
ONE HORSE PER ENTRY FORM
NCHA LEVELING WILL BE USED IN AMATEUR. A HORSE MAY BE ENTERED IN ALL THREE DIVISONS OF THE AMATEUR.
THE HORSE MAY ONLY BE SHOWN 2 TIMES IN A GO ROUND.
To email this form without saving first, you will need to have Acrobat Reader set as your default PDF Reader.
JANUARY 27 - FEBRUARY 6, 2022
Dellahillerman@gmail.com
Print completed entry form, then fax to 405-701-6726 or mail.
You can also SAVE this entry form and email to dellahillerman@gmail.com.
NOTE: YOU MUST SEND IN THIS ENTRY FORM AS INSTRUCTED ABOVE TO ENTRY.
CC:
MM: YY: CVC:
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