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(360) 942-3466 • PO Box 706, Raymond, WA 98577

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REGISTRATION FORM

Registration Form for Trail Challenge, Saturday July 13, 2013

Make checks payable to PCHLV

Print and send to WSU Extensions Office, Attn: Val Rowe PO Box 88, South Bend, WA. 98586

For More Info: Call Val Rowe 360-942-7422 or e-mail: twinharbortack@yahoo.com

$25.00 pre register by 7/1/13

$

$30.00 after 7/1/13

$

Stall Fee: $10.00/day

$

Camping Fee: $20.00/day (Camper, RV, etc.)

$

                       $10.00/day (Tent)

$

 

TOTAL: $__________________

 

*If you would like a practice run through course, sign up Saturday morning at the show office ($5.00/run)

 

Name: _______________________________________________

 

Age Group: ____________________ Age: _______

 

Horse’s Name: _________________________________

 

Address: ________________________________________________________________

 

E-Mail: _____________________________________________________________

 

Phone Number: ______________________________________

 

Parent’s Signature (if under 18): _______________
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