NORTHUMBERLAND COUNTY RIDERS' HORSE CLUB

Number:_____________


Rider ___________________________________  Horse: ________________________________

Check Class # Classes    Adult: ___________ Member: ________ $4.00/class
  1
Open Halter
 Youth: __________ Non-member: _____ $5.00/class
  2
Open Showmanship  (17 & under as of Jan 1st) Date of Birth__________________
  3
Lead Line Under 4yrs must have a side walker(s)
  4
Walk Only - off lead line (Attendants allowed - but must not lead)
  5
Walk Trot/Jog Pleasure  
  6
Walk Trot/Jog Pattern    
  7
Green Horse Pleasure    
  8
Special Needs  
  9
Youth Western Pleasure
  10
Open Western Pleasure
  11 Open Western Horsemanship
  12 Youth English Pleasure
  13 Open English Pleasure              
  14 Youth English Equitation
  15 Adult Engilsh Pleasure
  16 Open Hunter Under Saddle  
  17 Open Pairs  
  18 Mystery Class
  19 Open Command
  20
Open Trail  
  21 Open Barrels  
  22 Open Pole Bending  
  23 Open Keyhole  
  24 Cross Rail   Number of Classes:
  25 Hunter Hack - 2'
_________X $4.00 = $ ________
  26 Baby Jumper - 2'0   _________ X $5.00 = $________
  27 Low Hunter - 2'3   Paid Cash ______
  28 Open Hunter - 2'6   Cheque ______ # _______
  29 Open Jumper - 2'6"


LIABILITY INSURANCE & WAIVER ON THE OTHER SIDE MUST BE SIGNED