Event Entry
  
* Indicates required field (Other fields will be required based on Classes selected.)
 *Event

   Horse

 Sex

 Year Foaled

Horse Papers MUST be faxed or Mailed to the NCHA office, before entry is valid.

Registration No

  Sire  

Rider

NCHA #

Rider DOB

  Month Day Year

Rider Email


*Make premium checks payable to: *S.S. or Corp ID #


*Owner   *NCHA #
*Address
*City

*State

*Zip Code *Country
*Phone  

*Email

*Re-Enter Email

Above email address will be used to send entry confirmation.

Correspondent   NCHA #
Address
City

State

Zip Code Country
Phone  

Email


*** FEE RECEIVED AFTER GRACE PERIOD IS SUBJECT TO A PENALTY FEE. ***
Please contact the NCHA Office for the Penalty Fee.
  Fee is due On or Before  

Class

  Apr 15 May 15 Penalty Fee
After Draw
*** Class and Fee must be selected before entry is VALID. ***
Open..................................................   $1,250 $1,390* $5,140*
John Deere Division of the Open...     $500   $750
Open Senior...............................     $500   $750
Open Gelding..............................     $500   $750
Non-Professional...............................   $1,250 $1,365* $5,115*

Non-Professional Senior...............

    $500   $750

Non-Professional Gelding..............

    $500   $750

Non-Pro/Limited Non-Pro Comb.....

    $970*   $1,445*
Limited Non-Professional..................   $1,560   $3,060*

Limited Non-Pro Senior.................

    $500   $750
Amateur............................................   $1,160*   $2,260*

Amateur Senior...........................

    $500   $750

Amateur/Unlimited Amateur Comb

    $620*   $920*

Unlimited Amateur.......................

  $1,160*   $2,260*

Unlimited Amateur Senior.............

    $500   $750
*** Class and Fee must be selected before entry is VALID. ***
*** FEE RECEIVED AFTER GRACE PERIOD IS SUBJECT TO A PENALTY FEE. ***
Please contact the NCHA Office for the Penalty Fee.

* Includes a $25 cattle surcharge, $15 Drug Fee and voluntary PAC Fee.
(PAC Fee = $100 for Open, $75 for Non-Pro, $20 for Limited Non-Pro,
$20 for Amateur, $20 for Unlimited Amateur)
Funding the PAC is important to be able to maintain state funding at the NCHA Triple Crown.
Select this option to opt out of PAC Fee.  Additional PAC Fee Contribution

* Name on Credit Card
* Payment   * Card #
* Expiration Date: MM
YY   * Security Code

Electronic Signature: Yes No
If "YES" is not selected then this entry form will not be accepted.
 

 
Clicking Submit button more than once could result in your Credit Card being charged more than once.
 

Signature (if form printed and mailed to NCHA): _____________________________________

Copyright ©National Cutting Horse Association All rights reserved. · Information in this document is subject to change without notice. v:2014