GIT UP & GLOW REGISTRATION
Mount Chance Farm, Clements, MD
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First Name
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Format: (000) 000-0000.
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Riders Full Name
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First Name
Last Name
Riders DOB: (If over 18, "adult" is acceptable.
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Horse/Pony Name: (Name you want announced)
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Current Coggins
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ALL WALK TROT CLASSES
$110.00
$
110.00
ALL WALK TROT CANTER CLASSES
$110.00
$
110.00
1. Keyhole WT
$12.00
$
12.00
2. Keyhole WTC
$12.00
$
12.00
3. Figure 8 Cowhorse WT
$12.00
$
12.00
4. Figure 8 Cowhorse WTC
$12.00
$
12.00
5. Scramble Race WT
$12.00
$
12.00
6. Scramble Race WTC
$12.00
$
12.00
7. Texas Rollback WT
$12.00
$
12.00
8. Texas Rollback WTC
$12.00
$
12.00
9. Pole Bending WT
$12.00
$
12.00
10. Pole Bending WTC
$12.00
$
12.00
11. Clown Hat Race WT
$12.00
$
12.00
12. Clown Hat Race WTC
$12.00
$
12.00
13. Hurry Scurry WT
$12.00
$
12.00
14. Hurry Scurry WTC
$12.00
$
12.00
15. Flag Race WT
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
16. Flag Race WTC
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
17. Barrel Race WT
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
18. Barrel Race WTC
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
19. Dollar Bareback WT
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
20. Dollar Bareback WTC
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
OFFICE FEE
$5.00
$
5.00
Payment Methods
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