ENTRY APPLICATION for

Unjudged trail obstacle ride, Oct 31-Nov 1, 2009

One per person please.

Name of Rider _____________________________________________

Age -(under 18 must wear helmet.)___________________________

Mailing Address_____________________________________________

City _______________________________ State Zip _______________

Phone (day) _____________________(evening) _________________

On-site cell number: ______________________

E-mail address: ____________________________________________

Name of horse’s owner (if other than rider): __________________

Phone _____________________________________________________

Breed of Horse __________________ Age _____ Sex _____

Horses Name_______________________________________________

Riding Saturday approx. time_______________________________       

Riding Sunday  approx. time________________________________

Need Stall ? (12x12 box stall) $10.00_________________________

Dish for Pot luck ?  If yes, what can you bring _______________

____________________________________________________________

Send registration form along with a $10 non-refundable deposit to address below BEFORE October 21^st deadline  OR  pre register on line and use pay-pal. Confirmation will be made upon receipt via phone or email..  In the case of a cancellation, credit will be granted for future Horselovers event.

NO DAY OF EVENT ENTRIES- ALL MUST PRE -REGISTER,

THIS FACILITY NOT OPEN TO GENERAL PUBLIC.  YOU WILL HAVE TO PRESENT SIGNED RELEASES BEFORE RIDING.

Thank you for understanding, we want to continue to be able to hold events at this beautiful farm.

Evon Montgomery                                          724-360-0171                                  347 Saxonburg Blvd.        ruggedcrossranch@pghmail.com                                 Saxonburg, Pa. 16056                     www.horseloversguide.com

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