NBHA

Illinois State Show Entry Form

September 17, 18, &19, 2010

Riders Name:_____________________________________________

Address__________________________________________________

NBHA District#_________NBHA#___________Phone#___________

Open 4D Barrels:__________________________$6,000.00Added_______

Horse’s Name__________________________________________$65.

Horse’s Name__________________________________________$65.

Horse’s Name__________________________________________$65.

Senior 4D Barrels__________________________$1,500.00______Added_____

Horse’s Name__________________________________________$40.

Horse’s Name__________________________________________$40.

Horse’s Name__________________________________________$40.

Youth 4D Barrels__________________________$1,500.00______Added____

Horse’s Name__________________________________________$40.

Horse’s Name__________________________________________$40.

Horse’s Name__________________________________________$40.

Entry Fees Total                                                                               $_____

$55. Stall x stalls (mandatory)                                                         $_____

One Time Processing Fee                                                                $25.00

Tough enough to wear PINK $1.00 Donation.                               $______

                                                                                             TOTAL $_________                                                                                                                  

Send Entries by August 15, 2010 (if entering day of show a $25. late fee will apply.)

Kay Reynolds

400 S 5^th ST SW 

Clay City, IL 62824 

Must be a paid Member of IL NBHA to participate in the State Show. Join at Show and run.  NO EXCEPTIONS.

If you wish to stalled with anyone, entries must be sent in together.

Gates will not open before noon, Thursday September 16, 2010. (Enforced so we can prepare for show.)

No Refunds