Midwest Appaloosa Classic

Midwest Appaloosa Classic
Entry form for ApHC participants (including WSCA classes)
Back # (leave blank and Wissota will assign)
Horse Name:
Horse ApHC #
Sex
Foal Date:
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
HORSE Special Eligibilities--Must show ApHC Verification
ROM:
Fees Paid By:
Owner:
Owner ApHC #
Address:
Phone #:
Owner Email
example@example.com
Exhibitor 1:
Exhibitor 1 ApHC #
Exhibitor 1 Birthday
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Exhibitor 1 Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Exhibitor 1 Phone #:
Category
Exhibitor 1 Classes Entered (Class # only; please separate with comma or semi-colon)
- Exhibitor 2:
- Exhibitor 2 ApHC #
- Exhibitor 2 Birthday
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Exhibitor 2 Address
  Street Address
  Street Address Line 2
  CityState / Province
  Postal / Zip Code
- Exhibitor 2 Phone #
- Category
- Exhibitor 2 Classes Entered (please separate with comma or semi-colon)
- Exhibitor 3:
- Exhibitor 3 ApHC #
- Exhibitor 3 Birthday
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Exhibitor 3 Address
  Street Address
  Street Address Line 2
  CityState / Province
  Postal / Zip Code
- Exhibitor 3 Phone #
- Category
- Classes Entered (please separate with comma or semicolon)
- Please provide: Copy of ApHC registration papers, Coggins, and ApHC Card. Proof of green or novice eligibility if entering those classes
  Browse Files
  Cancelof
- How will you be paying? Classes can be added or dropped at the show
- Please Read the below COVID waiver fully before completing registration
- I acknowledge horseback riding is a sport which carries inherent risks of injury and damage to myself, others, horses and property. I knowingly assume all risks, including those related to COVID-19. I have read the above WSCA Covid-19 Waiver and agree to its terms. In consideration of my participation in this event, I will defend, indemnify and hold harmless any agents or employees of Simon Arena and/or the membership and/or the Board of Directors and Officers, agents and or employees of Wissota Appaloosa Horse Club against all claims, demands and causes of action, including court costs and actual attorney's fees arising from any proceeding or lawsuit brought by or prosecuted to my benefit. This agreement is binding to all my executors, heirs and assigns. My signature acknowledges that I have read this liability and medical release and know and understand it's contents.
- Signature: Every participant in this event must sign. If under 18 parent's signature is required.
  Clear
- Date:
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Should be Empty: