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


Premium checks will be made to registered owner of the horse.


*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 Fee

Class

Jan. 15
Paid in Full
Jan. 15 Feb. 15 Penalty After Draw
*** Class and Fee must be selected before entry is VALID. ***
Open.................................................... $2,450* $1,250 $1,450* $5,200*
John Deere Division of the Open.....     $535   $785
Open Senior.................................     $535   $785

Gelding Open.... ( Super Stakes)

    $535   $785

$10,000 Novice... ( Super Stakes)

    $535   $785
Non-Professional................................. $2,425* $1,250 $1,425* $5,175*

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

    $535   $785

Gelding Non-Pro. ( Super Stakes)

    $535   $785

$10,000 Novice... ( Super Stakes)

    $535   $785
Limited Non-Professional....................   $1,620*   $3,120*

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

    $535   $785
NonPro/Limited Non-Pro Combo.........     $1,230#   $1,817#
NonPro/Lmt Non-Pro Combo Rollover..     $1,230#   $1,817#
Amateur.............................................   $1,220*   $2,320*

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

    $535   $785
Amateur/Unlimited Amateur Combo..     $1,100#   $1,622#

Gelding Amateur ( Super Stakes)

    $535   $785
Unlimited Amateur..............................   $1,440*   $2,320*

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

    $535   $785

Gelding UnLmt Amateur ( Super Stakes)

    $535   $785
*** 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 $50 NCHA fee, $15 Drug Fee and voluntary PAC Fee.
# Includes a 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:2015