First Name		APPROVALS
Last Name		MHBHA Card #
Street Address		WPRA Card #
City		NWBRA Card #
State		NBHA Card #
Zip/Postal Code
E-mail

Pre-entries by 6-10-11 - Late Entries taken on site *YOUTH-12 years and under    * NOVICE HORSE-Horse cannot have over $500 lifetime earnings * RIR FUTURITY-No horse over the age of 5 years. Registration papers required * ONE TIME LATE FEE $10-If entering later than 6-10-11
Horse's Registered Name	Open 4D June 18 $75 $2,000 Added	Open 4D June 19 $75 $2,000 Added	Youth Side Pot June 18 $35 $100 Added	Youth Side Pot June 19 $35 $100 Added	Novice Horse Side Pot June 18 $35 $100 Added	Novice Horse Side Pot June 19 $35 $100 Added	RIR Futurity Side Pot June 18 $45 $300 Added	RIR Futurity Side Pot June 19 $45 $300 Added
Must enter and run in the Open 4D in order to enter and roll your time to the side pot races. 1D-2D-3D 1/2 Second Splits      4D 1 Second Split

Exhibitions	FRI		X $5 =
	SAT		X $5 =
Stalls	FRI		X $15=
	SAT		X $15 =
STALLING & CAMPING AT THE WYOMING STATE FAIRGROUNDS! Douglas, Wyoming

 

ENTRY FEE TOTAL
STALL TOTAL
EXHIBITION TOTAL
One Time Fee $10 (if later than 6-10-11)
Credit Card Fee 5% (Total X 5%)
TOTAL $
Credit Card: Mastercard Visa American Express Name On Card Number
Checks payable to River Island Ranch For further information: info@riverislandranch.com