Fillable NRHA & SWRHA APPROVED AQHA Approved Alliance Event (Harrel Show Secretary)

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NRHA & SWRHA APPROVED AQHA Approved Alliance Event (Harrel Show Secretary)

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HISTORY AND CHAMPIONS ENTRY # __________
NRHA & SWRHA APPROVED AQHA – Approved Alliance Event
March 26-28, 2021 Hardy Murphy Coliseum, Ardmore, Ok
Account Name: _____________________________________ Trainer: __________________________________________
(
Person Responsible for Paying)
NRHA Horse’s Name _____________________________________ Comp Lic # ______________ S G M
Horse’s Barn Name __________________________ AQHA # ________________ Yr Foaled:_____
Owner’s Name ______________________________________ NRHA # ________________
G P NP Y L
SSN# _____________________ AQHA # ________________ O AM N Y L
Owner’s Name ______________________________________ NRHA #________________ G NP Y L
SSN# _____________________ AQHA # ________________ O AM N Y L
Rider’s Name ______________________________________ NRHA #________________ P NP Y L
SSN# _____________________ AQHA # ________________ O AM N Y L
NO ADDRESS….NO SSN#.....NO PAYCHECK PAYEE: Rider or Owner
Address______________________________________________ City _______________________ State______ Zip ____________
Phone (______)____________________
E-mail ___________________________________________________________
Class Division Entry Judges
Order Class # Fee Fee Rider (if different from above) Pattern #
Friday, March 26 starting at 8:00 am
1
st
9003 Mens 30 0 _____________________ 6
9004 Ladies (Limited to 40 runs)
2
nd
1100 Open ($450) 45 25 __________________ NRHA #________ 4
1200 Int Open ($325) 30 25
1301 Ltd Open ($275) 25 25
1340 AQHA Open 30 0 __________________ AQHA #________
1350 Rookie Prof (JP) 25 25
Saturday, March 27 starting at 8:00 am
1
st
1430 Ranch Riding Open 30 0 _____________________ AQHA # _________ 4
2
nd
2430 Ranch Riding Am 30 0 _____________________ AQHA # _________ 4
3
rd
4430 Ranch Riding Yth 30 0 _____________________ AQHA # _________ 4
4
th
2342 AQHA Nov Am 30 0 __________________ AQHA #________ 8
5300 Rookie I (JP) 20 20 __________________ NRHA #________
5301 Prime Time Rookie (JP) 20
5310 Rookie II (JP) 20
5
th
1800 Nov Hor NP 1 (JP) 25 25 __________________ NRHA #__________ 6
1850 Nov Hor NP 2 (JP) 25
6
th
1700 Nov Hor Op 1 (JP) 25 25 __________________ NRHA #__________ 1
1750 Nov Hor Op 2 (JP) 25
7
th
10001 Green Level II 30 0 __________________ NRHA #__________ 6
10002 Green Level I 30
8
th
2400 NP Derby L4 (500) 50 35 _____________________ NRHA# _________ 5
2500 NP Debry L3 (300) 30 30
2625 NP Derby L1 (200) 20 20
Horse Name _______________________________________ ENTRY ___________
Sunday, March 28 starting at 8:00 am
1
st
3100 Yth 13 & U 10 0 __________________ NRHA #__________ 11
3200 Yth 14 –18 10
4347 AQHA 13 & U 10 __________________ AQHA #__________
4348 AQHA 14 - 18 10
2
nd
3500 Yth 10 & U 10 0 __________________ NRHA #__________ A
3
rd
1400 Non Pro ($450) 45 25 __________________ NRHA #__________ 8
1500 Int NP ($325) 30 25
1600 Ltd NP ($275) 25 25
1650 PT Non Pro (JP) 25 25
2340 AQHA Am 30 0 __________________ AQHA #__________
2348 AQHA Am Select 30 0
4
th
2100 Open Derby L4 (500) 50 35 _____________________ NRHA# _________ 5
2200 Open Debry L3 (300) 30 30
2325 Open Derby L1 (200) 20 20
FOR OFFICE USE ONLY
Entry fee total - - - - - - - - - - - - - = ________ ________
Judges fee total - - - - - - - - - - - - - - - = ________ ________
Office fee $40 (except Youth)- - - - - - - - - = ___40___ ___40___
Stall _____ x nights ______x 30/stall - - - - - - = ________ ________
Shavings ______ x $10/bag - - - - - - - - - - = ________ ________
RV _____ x Nights _______x $35/site - - - = ________ ________
Grounds fee $40 Per______ Day- - - - - - = ________ ________
Paid Warmup _____ X $30 per 6 min - - - - = ________ ________
AQHA Drug Testing $8.00/horse/show -
- - = ________ ________
NRHA Drug Fee $7/horse - - - - - - - - - -= ________ ________
Late Fee $50 for Derby Entries after 3/18 - - - = ________ ________
TOTAL FOR ONE HORSE _________ __________
Signature: ____________________________________________________________________ Date: ____________________, 2021
CC _______________________________________________ CVS _________ Exp _____________ Zip Code _______________
Name as appears on card _________________________________________________________________________
Credit Card (Info Above) V MC Dis Check # _______ PAID CK $________ CA $________ CC$______
Checks payable
to:
H M C
THIS ENTRY IS AN AGREEMENT THAT THE PERSON ENTERED, ALONG WITH THE OWNER, LESSEES, TRANER, MANAGER, COACH AND HORSE: (1) THAT EVERY
HORSE AND RIDER IS ELIGIBLE AS ENTERED; (2) THAT THE OWNER AND ANY OF HIS/HER REPRESENTATIVES WILL AGREE TO THE FINAL DECISIONS MADE BY
THE MANAGEMENT AND HOLD THE COMPETITION OF THE NRHA, AQHA, AND HARDY MURPHY COLISEUM., THEIR OFFICIALS, THE MANAGEMENT EMPLOYEES
AND AGENTS HARMLESS FOR ANY INJURY OR LOSS SUFFERED DURING OR IN CONJUNCTION WITH THE COMPETITION, WHETHER OR NOT SUCH INJURY OR
LOSS RESULTED, DIRECTLY OR INDIRECTLY, FROM THE NEGLIGENT ACTS OR OMISSIONS OF SAID OFFICIALS, EMPLOYEES, AGENTS, THE MANAGEMENT, NRHA,
AQHA OR HARDY MURPHY COLISEUM. WARNING, UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), A FARM ANIMAL PROFESSIONAL IS
NOT LIABLE FOR AN INJURY TO OR THE DEATHOF A PARTICIPANT IN FARM ANIMAL ACTIVITIES RESULTING FROM
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NRHA & SWRHA APPROVED AQHA Approved Alliance Event (Harrel Show Secretary)

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Completed 6 May 2021

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