Print this form and mail along with entry fee to the address at the bottom of the form.

NORTH PACIFIC REGIONAL CHAMPIONSHIP
JULY 24-26, 2009
Klickitat County Fairgrounds - Goldendale, WA
ALL FORMS AND FEES MUST BE POSTMARKED BY JULY 16 FOR PRE-ENTRY DISCOUNT
Name:_________________________________________ Birth Date:__________
Address:__________________________________________________________
City:______________________State:_________________Zip:_______________
 Phone:____________________________EMail:__________________________
CMSA#____________Class:________________Horse Name:_______________

ADD ADDITIONAL FAMILY MEMBERS TO THIS FORM (USE REVERSE IF NEEDED)

Name:_________________________________________ Birth Date:__________
CMSA#____________Class:________________Horse Name:_______________

Adults, Seniors, Juniors pre entry  

$175

$________

Wranglers pre entry

$50

$________

Adults, Seniors, Juniors at the gate 

$195

$________

Wranglers at the gate

$75

$________

Eliminator: Graduated Entry Fee By Division

1: $20   2:$40   3: $60   4:$80   5: $100  6: $120  

Div ______

$________

Rifle

$50

$________

Shotgun

$50

$________

Time Only: Stages 1-2 and 4-5 only

$40

$________

Indoor bedded stalls/weekend (Fri-Sun Only)

$50

$________

Thursday night bedded Stall

$17

$________

Large outdoor stock pens (for multiple horses only)

$50

$________

Hookups per weekend

$50

$________

Dry Camping

Free

 

Saturday night dinner included with every entry

Free

 

Extra Dinner Tickets

$12

$________

TOTAL

 

$________

No horses allowed in RV camping area. Dogs must be leashed.
Stalls must be cleaned prior to leaving the fairgrounds or a $25 fee per stall will be assessed. 
Must make stall and/or RV reservation with Lana Martin by pre-entry cut off date to guarantee reservation. Lana.Martin@tqs.com  or call: 503-922-9409.
Stalls and pens are first come first served based on paid pre-entries. 
Large outdoor stock pens are limited and will only be assigned to those with 2 or more horses per pen.
Only paid RV parking will be allowed in RV area.  No tying to pens overnight.
No portable pens allowed, except to partition within a pen.
Stalls come with 2 bags of shavings, additional shavings available on site for purchase.

MAKE CHECKS PAYABLE AND MAIL TO:   WSMS c/o Nancy Martin:   PO BOX 1422 - Milton, WA 98354