NBHA

Illinois State Show Entry Form

September 16, 17, &18, 2011

Riders Name:_____________________________________________

Address__________________________________________________

NBHA District#_________NBHA#___________Phone#___________

Open 4D Barrels:__________________________$6,000.00Added_______

Horses Name__________________________________________$65.

Horses Name__________________________________________$65.

Horses Name__________________________________________$65.

Senior 4D Barrels__________________________$1,500.00______Added_____

Horses Name__________________________________________$45.

Horses Name__________________________________________$45.

Horses Name__________________________________________$45.

Youth 4D Barrels__________________________$1,500.00______Added____

Horses Name__________________________________________$45.

Horses Name__________________________________________$45.

Horses Name__________________________________________$45.

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.   

If you wish to stalled with anyone, entries must be sent in together. Please give NBHA#, Phone#, and District # if I need to contact you.

Gates will not open before noon, Thursday September 15, 2011. (Enforced so we can prepare for show.)

No Refunds