mark twain prize list 2012

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Mark T wa i n Fe s t i val Hor se S ho w

Presented By:

Bainbridge Farm, LLCTuesday & Wednesday

July 17-18, 2012

Chemung County FairgroundsHorseheads, NY


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Mark Twain Festival #6675

Rated A: Junior, Amateur-Owner, Pony, Green Pony Hunter

Rated C: Children's and Adult-Amateur Hunter


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F i r s t C l a s s

U . S . P

O S T A G E

P A I D

P e r m i t N o . 1

9

F a y e t t e v i l l e , N . Y .

1 3 0 6 6


23/24


24/24

H o r s e ' s U S E F / U S H J A #

1 s t o r

2 n d Y

r .

H e i g h t

C o l o r

A g e

S e x

N a m e o f R i d e r

N a m e o f R i d e r

R i d e r ' s U S E F #

R i d e r ' s U S E F #

O N E H O R S E T O E A C H E N T R Y B L A N K

__________

E n t r y N u m b e r

W r i t e C l a s s # s B

e l o w N a m e o f C o r r e s p o n d i n g

R i d e r

H o r s e N o .

O f f i c e U s e

O n l y

N A M

E O F H O R S E

U S E F F e e ( D & M $ 8

, U S E F $ 8 )

$ 1 6 . 0 0

U S E F N o n - M

e m b e r F e e @

$ 3 0

. 0 0

U S H J A N o n - M

e m b e r F e e @

$ 3 0

. 0 0

G r o u n d s F e e $ 4 0

. 0 0 ( I f n o

s t a l l p u r c h a s e d )

E M T & I n s u r a n c e F e e

$ 3 5 . 0 0

S h a v i n g s

U S H J A Z o n e F e e @

$ 2 . 0 0

$ 2 . 0 0

T o t a l A m o u n t

A m o u n t E n c l o s e d

B a l a n c e D u e

T O T A L E N T R Y F E E S

E N T R Y

F E E S

M a r k T w a i n F e s t i v a l H o r s e S h o w

C h e m u n g

C o u n t y F a i r g r o u n d s

H o r s e h e a d s , N Y

S t a l l s f o r 2 s h o w s @ $ 2

3 5 b y J u l y 5 h

S t a l l s M T @

$ 1 1 5 . 0 0 p a i d b y J u l y 5 t h

S t a l l s M T @

$ 1 3 0

. 0 0 p a i d

a f t e r J u l y 5 t h

C a m p e r F e e @ $ 3 0 . 0 0

p e r d a y / n i g h t

M A K E C H E C K S P A Y A B L E T O

:

E q u i n e P r o d u c t i o n s & M a r k e t i n g

R e t u r n T o : M A R K T W A I N

F E S T I V A L H O R S E S H O W

P . O . B o x 4 5 5 ,

F a y e t t e v i l l e , N . Y . 1 3 0 6 6

P h o n e : ( 3 1 5 ) 4 3 6 - 1 9 3 3

B e

f o r e J u l y 1 5 t h : F a x : 3 1 5 - 6 8 2 - 9 4 1 6

A n y d a t e : n b l u m

e n t h a l @ t w c n y . r r . c o m

E n t r i e s C l o s e 6 P M N i g h t B e f o

r e S h o w

P o s t e n t r i e s a c c e p t e d a t r e g u

l a r f e e s

P o n i e s S p e c i f y : S m a l l_____

M e

d i u m_____

L a r g e_____

A m a t e u r s S p e c i f y : 1 8 - 3 5____

3 6 & O____

J u n i o r H u n t e r s S p e c i f y : S m a l l____

L a r g e____

R i d e r ' s A S P C A #___________

___

J r & C h i l d r e n ' s R i d e r ' s A g e :___

__

1 5 Y r s & U

_____

1 6 - 1 7 Y r s

J r & A m a t e u r R i d e r s D O B___________________________________

F u l l p a y m e n t o r

s i g n e d c h e c k

m u s t b e l e f t w i t h t h e

s e c r e t a r y b e f o r e

n u m b e r s w i l l b e i s s u e d .

P r i n t R i d e r ' s N a m e

P r i n t T r a i n e r ' s N a m e

P r i n t O w n e r ' s N a m e

_____________________________________

________________

__________________________________________________________

________________________________________________

S t r e e t

S t r e e t

S t r e e t

_____________________________________

________________

__________________________________________________________

________________________________________________

C i t y

S t a t e

Z i p

C i t y

S t a t e

Z i p

C i t y

S t a t e

Z i p

_____________________________________

________________

__________________________________________________________

________________________________________________

T e l e p h o n e

U S E F #

T e l e p h o n e

U S E F #

T e l e p h o n e

U S E F #

_____________________________________

________________

__________________________________________________________

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E m a i l

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P r i n t C o a c h ' s N a m e

U S E F #

S t a l l s M u s t B e P a i d

I n F u l l B y J u l y 5 t h w i t h a

n e g o t i a b l e c h e c k i n o r d e

r t o q u a l i f y f o r t h e l o w e r f e e .

S t a l l s R e s e r v e d f o r M

a r k T w a i n o n l y m u s t b e

v a c a t e d b y 4

P M W e d n e s d a y

C o m p

l e t e f e e d o r d e r f o r m

M a i l R e c e i v e d A f t e r J u

l y 1 3 t h M a y N o t B e P i c k e d U p

G o T o : w w w . h o r s e s h o w i n g

. c o m t o m a k e y o u r e n t r i e s o n l i n e

N o C h a r g

e T o E x h i b i t o r s

mark twain prize list 2012

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