Jambalaya AMHA Miniature Horse Show - MAMHC Sponsored Show - June 26th and 27th 2010

 

Name:

 

 

 

 

 

 

Office fee Per Horse

 

x $  5.00

 

Address:

 

 

 

 

 

 

AMHA Fee

 

x $  2.00

 

City, State, Zip:

 

 

 

 

 

 

Amateur/Open Class Entry

 

x $25.00

 

Phone:

 

 

 

 

 

 

Youth Class Entry

 

x $20.00

 

Email:

 

 

 

 

 

 

Class #108, #161

 

x $10.00

 

 

 

 

 

 

 

 

Youth Versatility  #173

 

x $15.00

 

If a horse’s Class Entries total over $100 please use the Flat Rate Entry Fee for that horse

 

 

 

 

**

Flat Rate Entry $100 Per Horse       (Pre-entry Rate)

 

x$100.00

 

 

 

 

 

 

 

 

Stalls- Please Enter Total

 

 

 

Costume Class 246 is Free

Just Enter class number below

 

 

 

From Stall reservation sheet

 

 

 

 

 

 

 

 

 

 

Total Enclosed

 

 

 

 

 Full AMHA Registered

Exhibitor

 

 

 

 

 AMHA

 

 

Registered Owners

Office Use Only

Name of Horse

 Name(S)

Class Number

Reg #

Age

Sex

Name and Address

Height

Show #

 

 1)

 

 

 

 

 

 

 

 

 

 

 

 2)

 

 

 

 

 

 

 

 

 

 

 

1)

 

 

 

 

 

 

 

 

 

 

 

2)

 

 

 

 

 

 

 

 

 

 

 

1)

 

 

 

 

 

 

 

 

 

 

 

2)

 

 

 

 

 

 

 

 

 

 

 

1)

 

 

 

 

 

 

 

 

 

 

 

2)

 

 

 

 

 

 

 

 

 

 

 

1)

 

 

 

 

 

 

 

 

 

 

 

2)

 

 

 

 

 

 

 

 

 

 

 

______________________________               _______________________________               _______________________________               ______________________________

Signature of Amateur and Number                       Signature of Amateur and Number                              Signature of Youth and Number                      Signature of Youth and Number

 

This form must be signed in order to participate in the show.  This show is approved and conducted under the rules of AMHA and is open only to horses registered with AMHA.  I hereby enter these horses in the classes listed above.  By so entering, I agree to abide by and be bound by all rules and regulations of AMHA, Hoosier Horse Park, and Mid-America Miniature Horse Club.  I agree to hold harmless the managers and sponsors of the show from all liability in case of accident, theft, injuries or loss in any way associated with my participation in this event.  Under Indiana Law (an equine professional is not libel for any injury to or the death of a participant in equine activities resulting from the inherent risk of equine activities.  My signature is proof that I have read, understand, and agree to accept this Statement.

                                                                                                                                                                  Make Checks payable to:  MAMHC

______________________________________                ________________________________________                            Mail Entries to: Kimberly Sullivan

Signature of Exhibitor                                                                Signature of Parent or Legal Guardian                                          289 Galloway Rd.  Stamping Ground, KY 40379