2008 OHIO NBHA  STATE CHAMPIONSHIPS

One entry form per person.  Entries must be postmarked by JUNE 25 2008

(This entry form must be filled out complete or it will not be accepted)

Anyone wanting to be stalled with a group, ALL entries must be received in the same envelope

 Assigned by order entries received.

Name:                                                                                                                          Make checks payable to:

Address:                                                                                                                                   OHIO NBHA

City:                                                                                                                             Mail completed entry form to:

State:                                                    Zip:                                                                              Cara Kaufman

Phone:                                      Email:                                                                                       6219 TR 265

NBNA Membership #:                                                                                                          Millersburg, OH 44654

OHIO District # compete in:  ______________                                                                   330-674-4189

Birth date (Required for Youth and Senior Entries)                        /           /          

Class                                                               HORSE NAME                                 FEE                                   AMOUNT

NBHA                         1^st horse:                                                                                  $65.00                           $                               

OPEN                         2^nd horse:                                                                                  $65.00                           $                               

4-D                              3^rd horse:                                                                                  $65.00                           $                               

                                                LATE FEE PER ENTRY TOTAL $100.00

NBHA                         1^st horse:                                                                                  $40.00                           $                               

YOUTH                      2^nd horse:                                                                                  $40.00                           $                               

3-D                              3^rd horse:                                                                                  $40.00                           $                               

                                                LATE FEE PER ENTRY TOTAL $60.00

NBHA                         1^st horse:                                                                                  $35.00                           $                               

SENIOR 3-D              2^nd horse:                                                                                  $35.00                           $                               

(50 & OVER)             3^rd horse:                                                                                  $35.00                           $                               

                                                LATE FEE PER ENTRY TOTAL $55.00

                        # OF STALLS NEEDED                                 (One horse per stall)     $60.00 EACH                $                                includes 1 bag

                        CAMPER HOOKUP                                                                          $60.00 EACH                $                               

                        OFFICE FEE                                                                                       $15.00 PER HORSE/RIDER  $                              

                        ADDITIONAL HORSE/RIDER________                                          $5.00                                       $___________________

NON STALLED HORSE                                                                    $10.00 PER HORSE     $                               

                                                                                                                                    TOTAL                         $                               

MUST SIGN WAIVER ON BACK

 All returned checks - $50.00 fee and NBHA membership barred until paid in full                      NO REFUNDS

NO TIE OUT RULE

MUST CHECK IN WITH THE ALLY CONTROL MANAGER 10 HORSES BEFORE YOUR RUN OR YOU WILL BE DQ.