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Fall Pace Results 2020
ONLY 1 Rider Per Entry... Before beginning, have the horse coggins #, date, state drawn information handy! It will save you time at check-in.
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* Indicates required question
First Name of Rider
*
Your answer
Last Name of Rider
*
Your answer
Select Division:
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Full Cry: Fast pace with jumps
Second Flight: For Riders who enjoy a challenging ride, jumps optional
Hilltoppers/Trail: A relaxed and leisurely stroll through foxhunting country
Juniors: One rider on the team must be 17 or under
Required
Team Mate Name(s): Teams of 2 - 3 riders.
*
Your answer
Is Rider a Junior? (17 & Under}
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Yes
No
Method of Payment
Please select your method of payment below. Note the Credit Card and PayPal link is on our website. Payment method must be received by Friday, April 22nd (5 PM)... For questions regarding payment, contact the event coordinator: Carol Demeo 352.249.6555
carolddemeo@gmail.com
What method of payment will you be using?
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Credit Card - use link on our website
PayPal - use link on our website
Bringing payment the day of the event
Special Instructions Payments (paying for who? self or another rider)
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Your answer
Waiver Acceptance and Signature:
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To view and read the waiver please click the link on our website
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the waiver.
Required
Electronic Signature
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Please type your first and last name
Your answer
Electronic Signature for a minor
Please type your first and last name of parent or legal guardian
Your answer
E-mail address
Your answer
Phone #
*
Your answer
Mailing address
*
street
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Name of Horse
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Your answer
Coggins Accession #
(please bring a copy to the event if not sent in at the time of registration)
Your answer
Date blood drawn
MM
/
DD
/
YYYY
State blood drawn
Your answer
Horse owner
same as rider
Owner Name
Your answer
Owner phone #
Your answer
Owner email
Your answer
Emergency Contact Information
*
Please list emergency contact name
Your answer
Phone number
*
Your answer
Relationship
*
Your answer
Please list any known pertinent medical conditions in case of an accident
Your answer
How did you hear about our Hunter Pace?
*
Please check all that apply
Glenmore Hunt Club member
Friend/Family
Email notice
Facebook (if in a group please list name of group under other)
Google group or other social media
Flier
Newspaper
Other:
Required
Would you like to be added to our email list and receive notifications of other available events?
*
Please note that we DO NOT share your information with ANYONE and the notices will be limited to Glenmore Hunt activities and events.
yes
no
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