Name of Horse or Pony Class Numbers                  
                     
                     
Owner Information Rider Information                
Name                                                  Name                                                                   
Address Address                
City City                  
State & Zip State & Zip                  
Trainer         FEES: Make checks payable to WTHJA
Email address (if you would like to receive         DIVISION       $40.00
prize lists and other announcements):         INDIVIDUAL CLASS     $15.00
          SCHOOLING FEE (PER HORSE)   $15.00
          NON-SHOWING HORSE FEE - $10.00  
          MEDIC FEE (PER RIDER) - $5.00    
          GROUNDS FEE (NON-STABLED) - $25.00  
FOR MORE INFORMATION & STALL RESERVATIONS: #________STALLS @ $60.00    
ANN FORD UPSHAW (901) 497-9874 #________TACK STALLS @ $60.00  
OR EMAIL:AFU@BELLSOUTH.NET #________SHAVINGS @ $6.00    
          #________T-SHIRTS @ $15.00    
                     
Warning:  Under Tennessee Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from
the inherent risks of equine activities, pursuant to TCA, Title 33, Chapter 20.                  
Signing and presenting this form shall be deemed acceptance of the above terms and agreement to comply with the rules and regulations listed in   
the prize list and on this entry form.                    
                   
Signature of Exhibitor/Guardian:                                                                Date: