Entry Form KED Dressage & White Bridge Farm Schooling Shows 2012

Only 1 horse per entry.

Make check out to KED Dressage
Mail to : Katja Eilers
252 Beach Street
Litchfield, CT 06759
Entry Fees : $30 per class
XX negative Coggins must accompany entry XX
Show Date :
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Name of Horse :
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Classes entered
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______Total Fees :
Please check one : ( ) JY, ( ) YR ( ) AA, ( ) Open
Rider's Name
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Address
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City:
Zip :

State:

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Phone :

Fax :

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__Email Address :
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Signature :
Adult Signature if Rider is under 18:
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Jr/Yr Birthdate :
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