Shenandoah Riding Cinter  

200 N Brodrecht

 

Galena

 
IL 61036  
 
Closing  Date -  May 7, 2007
             
Rider / Handler Name IDCTA #
             
Horse's Name Sex (M, G, S)
  Adult Amateur (22 & over)     Junior/Young Rider (21 & under)
             
Address City
             
State Zip Phone #
             
Owner's Name IDCTA #
             
Address  City
             
State Zip Phone #
             
Stable with Approx. arrival time & date
Division   Class # and Class Description Fees
       
           
       
           
       
           
       
           
Total Class Fees  
Office Fee $10.00
Stabling Fee (Overnight Board, Day Stall or Haul-in Fee)  
Total Fees  
Make Checks payable to: Shenandoah Riding Center
Entries will not be accepted without:
This form fully completed   Correct Payment in full   A Copy of a Current, negative Coggins Test
Please note:  All riders under age 18 MUST wear an ASTM approved helmet and be accompanied by an
adult to sign liability waivers.