Back# INDIANA PAINT HORSE CLUB ENTRY FORM/TABSHEET Entered in Computer ____
to be used at June 13, 2015 Rochester, IN show only
THIS PRE-ENTRY FORM TO BE USED ONLY FOR JUNE 13, 2015 SHOW
AT FULTON COUNTY EQUESTRIAN CENTER, ROCHESTER, IN
Please complete pre-entry form and email to: . Pre-entry form can also be printed
out and completed. Please mail printed form to: Jerry Wyrick, 12336 N 2850 East Rd., Ellsworth, IL 61737
DO NOT SEND A CHECK FOR YOUR PRE-ENTRIES.
This form should not be used to request stalls. Please contact Show Manager Pauli Crull (574) 278-7487 or (574) 870-4686, or email at .
Name of Individual Responsible for Payment of Tabsheet
Yes, please email my receipt to me at (email address):
Stalls Reserved Under: (A) Open Exhibitor
APHA Membership #
City, State
Date of Show __June 13, 2015______Relationship to Owner
Show Location __Rochester, IN______(B) Amateur Exhibitor
APHA Membership #
Horse’s Name Amateur #/Date of Birth /
Horse’s APHA # City, State
Registry: Regular Solid Paint Bred Relationship to Owner
Year Foaled M G S (C) Youth Exhibitor
Coggins Date: APHA Membership #
Owner Youth #
Address Youth Date of Birth
City, State, ZIP City, State
Phone Relationship to Owner
Total Amount of All Day Fees From Reverse Side ______X Number of Judges (__2___) ______
Total Amount of Class Fees From Reverse Side ______X Number of Judges (__2___) ______
APHA Fees - $2 per judge X Number of Judges (_2_) 4.00
Number of stalls (____) x Stall fee ($30) OR Jumpout Fee (___$15.00____) ______
Misc Fees (Camping $20/day, Other ______) ______
INPHC Office Fee ($3 per horse/per judge) 6.00
INPHC Membership (Youth $8, Single $15, Family/Business $25) ______
Total Amount Due (Paid: Cash ______Check# ______) ______
Name of responsible party: Horse Name:
Exh A, B or C / $7/class or $40 all-day fee(Payback classes not eligible for all-day fee) / Exh A, B or C / $7/class or $40 all-day fee
(Payback classes not eligible for all-day fee) / Exh A, B or C / $7/class or $40 all-day fee
(Payback classes not eligible for all-day fee)
1. Amateur Stallions / 40. Solid Paint Bred Yearling Longe Line / 79. Open Western Pleasure (Payback)
2. Amateur Solid Paint Bred Stallions / 41. Open Hunter Under Saddle (Payback) / 80. Walk Trot Western Pleasure (5-10)
3. Solid Paint Bred Stallions / 42. Walk Trot Hunter Under Saddle (5-10) / 81. Amateur Walk Trot Western Pleasure
4. Yearling Stallions / 43. Amateur Walk Trot Hunter Under Saddle (19 & Over) / 82. Walk Trot Horsemanship (5-10)
5. 2 Year Old Stallions / 44. Walk Trot Hunt Seat Equitation (5-10) / 83. Amateur Walk Trot Horsemanship
6. 3 Year Old Stallions / 45. Amateur Walk Trot Hunt Seat Equitation (19 & Over) / 84. Green Western Pleasure
7. Aged Stallions / 46. Green Hunter Under Saddle / 85. Novice Youth Western Pleasure
8. Youth Geldings / 47. Novice Youth Hunter Under Saddle / 86. Novice Amateur Western Pleasure
9. Amateur Geldings / 48. Novice Amateur Hunter Under Saddle / 87. Junior Western Pleasure
10. Youth Solid Paint Bred Geldings / 49. Youth Hunter Under Saddle (18 & Under) / 88. Youth Western Pleasure (18 & Under)
11. Amateur Solid Paint Bred Geldings / 50. Amateur Hunter Under Saddle / 89. Amateur Western Pleasure
12. Solid Paint Bred Geldings / 51. Junior Hunter Under Saddle / 90. Youth Solid Paint Bred Western Pleasure
13. Yearling Geldings / 52. Youth Solid Paint Bred Hunter Under Saddle / 91. Amateur Solid Paint Bred Western Pleasure
14. 2 Year Old Geldings / 53 Amateur Solid Paint Bred Hunter Under Saddle / 92. Solid Paint Bred Western Pleasure
15. 3 Year Old Geldings / 54. Solid Paint Bred Hunter Under Saddle / 93. Senior Western Pleasure
16. Aged Geldings / 55. Senior Hunter Under Saddle / 94. Novice Youth Horsemanship
17. Overo Color / 56. Novice Youth Hunt Seat Equitation / 95. Novice Amateur Horsemanship
18. Tobiano Color / 57. Novice Amateur Hunt Seat Equitation / 96. Youth Western Horsemanship (18 & Under)
19. Open Showmanship (Payback) / 58. Youth Hunt Seat Equitation (18 & Under) / 97. Amateur Horsemanship
20. Walk Trot Showmanship (5-10) / 59. Amateur Hunt Seat Equitation / 98. Youth Solid Paint Bred Horsemanship
21. Amateur Walk-Trot Showmanship (19 & Over) / 60. Youth Solid Paint Bred Hunt Seat Equitation / 99. Amateur Solid Paint Bred Horsemanship
22. Novice Youth Showmanship / 61. Amateur Solid Paint Bred Hunt Seat Equitation / 100. Youth Pole Bending (18 & Under)
23. Novice Amateur Showmanship / 62, Youth Hunter Hack (18 & Under) / 101. Amateur Pole Bending
24. Youth Showmanship (18 & Under) / 63. Amateur Hunter Hack / 102. Pole Bending
25. Amateur Showmanship / 64. Hunter Hack / 103. Youth Solid Paint Bred Pole Bending
26. Youth Solid Paint Bred Showmanship / 65. Youth Solid Paint Bred Hunter Hack / 104. Amateur Solid Paint Bred Pole Bending
27. Amateur Solid Paint Bred Showmanship / 66. Solid Paint Bred Hunter Hack / 105. Solid Paint Bred Pole Bending
28. Youth Mares / 67. Lead Line (3-8) / 106. Youth Stake Race (18 & Under)
29. Amateur Mares / 68. Walk Trot Trail (5-10) / 107. Amateur Stake Race
30. Youth Solid Paint Bred Mares / 69. Amateur Walk Trot Trail (19 & Under) / 108. Stake Race
31. Amateur Solid Paint Bred Mares / 70. Green Trail / 109. Youth Solid Paint Bred Stake
32. Solid Paint Bred Mares / 71. Novice Youth Trail / 110. Amateur Solid Paint Bred Stake Race
33. Yearling Mares / 72. Novice Amateur Trail / 111. Solid Paint Bred Stake Race
34. 2 Year Old Mares / 73. Youth Trail (18 & Under) / 112. Youth Barrel Racing (18 & Under)
35. 3 Year Old Mares / 74. Amateur Trail / 113. Amateur Barrel Racing
36. Aged Mares / 75. Trail / 114. Barrel Racing
37. Amateur Yearling Longe Line / 76. Youth Solid Paint Bred Trail / 115. Youth Solid Paint Bred Barrel Racing
38. Yearling Longe Line / 77. Amateur Solid Paint Bred Trail / 116. Amateur Solid Paint Bred Barrel Racing
39. Amateur Solid Paint Bred Yearling Longe Line / 78. Solid Paint Bred Trail / 117. Solid Paint Bred Barrel Racing