SSRWSHA
Clarcona Show Entry Form

Please Complete This Form: Print, Sign & Send

Submit Via:  Fax (352) 796-0298 or by Mail:  SSRWSHA PO Box 10357 Brooksville, FL 34603
 
Walking Horse Registration #

Padded
Flat Shod		 Racking Horse Registration #

Padded
Flat Shod		 Spotted Horse Registration #
Horse's Name
 Rider
SSRWSHA Member
Non-Member		 Owner
SSRWSHA Member
Non-Member

Name Of Owner

Address

 City, State, Zip

Phone
  
Trainer's Name

Trainer's #
 Address

City, State, Zip
 Walking
Racking
Spotted
Class # Name Of Rider Rider Card # Fee
                                                                                                  Total Entry Fees
Stall Bedding 
Other Charges:
Affiliation Fee:
6.00
Stall Fee  Tack Stall Fee  Total Fees Included
I hereby certify that every horse is eligible as entered and sound and I agree to abide by the rules of the Sunshine State Racking, Walking & Spotted Saddle Horse Association (SSRWSHA) & The National Horse Show Commission (NHSC).  All decisions of the SSRWSHA & NHSC will be final.  Exhibitor, trainer or agent must sign entry blank or class sheet.  If not signed, the first entrance into the ring as an exhibitor shall be construed as acceptance of this and all other rules.  The NHSC, The SSRWSHA, or The Clarcoan Horsemen's Park assumes no liability for injury to horses, exhibitors or spectators or for loss or damage to property or for any accident or theft occurring at this show.

Signature of Owner/Exhibitor ___________________________________________________

©2005 SSRWSHA
All Rights Reserved.