ORUSPC Quiz Rally - Entry Form 2022. Saturday March 12 at Sisters Elementary School, Sisters, OR.  Check-in will start at 7am the day of the rally.
Complete one form per team. A full team is 4 competitors, a short team is 3 competitors. Divisions are as follows (age as of 1/1/2022)
Novice D = Age 5 -11, Unrated through D3
Junior D = Age 12-17, Unrated through D3
Senior D = Age 18+, Unrated through D3
Novice/Junior C/B/A = under 18, C1 through A
Senior C/B/A = Age 18+, C1 through A
Your DC/CA or a designated parent should register teams....please no individual entries unless you are a catch rider looking for a team and you have talked with your DC/CA about entering as an individual. Entry fee is $60 for USPC members, $70 for non-members. The entry includes lunch with vegetarian options. (see the end of entry form).  NO ENTRY IS CONSIDERED COMPLETE WITHOUT PAYMENT. PLEASE PAY AS SOON AS FORM IS SUBMITTED. Questions?  email: oregonregionboard@gmail.com
We will be following COVID protocols and will update with specific details nearer the event.
Closing Date: February 12 2022.  Changes to entries made after February 12 will only be made in emergency situations.  There will be NO REFUNDS of any kind, except with an official Doctor's note.
ORUSPC is committed to the full inclusion of all pony club members. As part of this commitment, ORUSPC will work to ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the rally, please contact Elizabeth Larson, VRS of Community at larsoneliz2010@gmail.com
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As per the Fall 2021 Council meeting a motion was passed to give all ORUSPC 2022 members a $100 voucher to use for pony club activities in 2022. To qualify, members had to have paid both National and Regional dues and be a member in good standing. Please list below anyone on this entry form who wants to apply their $100 voucher toward quiz rally entry. (If none, write NONE) *
Name of Pony Club or Center *
Name of person completing this form:           *
Email address of person completing this form: *
Phone number of person completing this form: *
List here any NON USPC members that you are entering on this form (this is for insurance purposes) Write N/A if not applicable *
Team/Individual Division:  Divisions are based on age as of Jan 1st of the current competition year. *
Competitor 1 Information:
Name: *
Age as of Jan 1, 2022: *
Contact Email: *
Contact Phone number: *
Team Captain: *
HM Certification (as of February 12, 2022) *
Qualifying for Champs? *
If Catch Competitor, Name of Club
Competitor 2 Information:
Name
Age as of Jan 1, 2022
Contact Email
Contact Phone number
Team Captain:
Clear selection
HM Certification (as of Feb 12, 2022)
Qualifying for Champs?
Clear selection
If Catch Competitor, Name of Club
Competitor 3 Information:
Name
Age as of Jan 1, 2022
Contact Email
Contact Phone number
Team Captain:
Clear selection
HM Certification (as of Feb 12, 2022)
Qualifying for Champs?
Clear selection
Competitor 4 Information:
Name
Age as of Jan 1, 2022
Contact Email
Contact Phone number
Team Captain:
Clear selection
HM Certification (as of Feb 12, 2022)
Qualifying for Champs?
Clear selection
Chaperone
Each team is required to have a chaperone. The chaperone must be onsite at all times that the team is onsite.
In the case of a catch team, you may have multiple chaperones by club but this is not required.  One chaperone per team is adequate.
*Senior competitors do not need a chaperone
Chaperone Name
Chaperone Email
Chaperone Phone
Volunteer Information
Each team is required to provide two volunteers. Senior and catch competitors do not need to provide volunteers, but are very welcomed! Lunch will be provided for volunteers
Rally organizers will contact volunteers directly with their volunteer assignment.
Volunteer #1 Name
Volunteer Email
Volunteer Phone #
Volunteer #2 Name
Volunteer #2 Email
Volunteer #2 Phone #
Registration Fee
Please submit $60 per competitor ($70 if non-Pony Club member).Entry includes a box lunch and snacks for competitors, please fill in below if vegetarian lunch requested

We will have lunch available for competitors and volunteers. Please fill in this part of the entry form with the name(s) of anyone needing a vegetarian option
Method of payment (see below for details of how to use paypal or send check) *
Please enter total amount being paid for team or catch competitor. Entries are not considered complete until payment has been received. Please list any members who are claiming the ORUSPC voucher to be used for quiz rally entry (check your entry above to cross reference you have the same names!) *
Payment Options
Payment can be made via PayPal using the QR code below/ pay to oregonregionboard@gmail.com
OR, you may send a check to Kara Warner, ORUSPC Treasurer, 16293 SW Bell Rd.
Sherwood, OR 97140
Paypal for ORUSPC Quiz rally payment
If you have any questions please leave them here and a rally organizer will contact you promptly
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