|
for a printable version of this form |
Entry
Form  Entry Forms must be returned by August 1, 2008 to : Nikki Medalen, 7049 Willow Road, Towner, ND, 58588 |
Sale: November 1st , one hour following the show (approximately) 2:00 pm |
ENTRY DEADLINE DATE: MUST BE RECEIVED BY: 8/1/2008 – subject to $50 late fee
Owner Name :________________________________Farm/Ranch Name:______________________________
Address:_____________________________________City:__________________State/Prov.:______________
Postal Code:________________ Phone:_____________________ Email:______________________________
Owners Social Security # (required for tax purposes): ______________________________________________
Breeder:____________________________________ Address: _______________________________________
Trainer:_____________________________________Address:_______________________________________
Rider:_______________________________________Address:______________________________________
Rider’s DOB: ________________________________Amateur #:_____________________________________
Horse’s Name:________________________________ Registration #:_________________________________
DOB:____________________ Breed:____________________ Color: _________________________________
Stallion [ ] Gelding [ ] Mare [ ]
$150 Office Fee, payable to Dakota 50/50 Futurity and Sale must be included with entry.
A copy of the registration papers with current owner showing and a negative Coggins test must accompany all horses to the Futurity – this is a facility rule. Health Certificates will be required on all horses coming from out of North Dakota.
All owner/exhibitor and/or otherwise responsible party is assumed to have thoroughly reviewed all Rules and Regulations of the Dakota 50/50. Please note new rules relating to Illegal Practices and Conduct.
Signature: ______________________________________________ Date: _____________________________
Return Forms to:
Nikki Medalen
7049 Willow Road
Towner, ND 58788
701-537-5548