NMRHA Derby
3, 4, 5 & 6 Year Old Entry Form
Derby babies pay only the $50 Office Tracking Fee.
Owners Name: __________________________________email:_________________________________
Address: ____________________________________________________________________________
City/State/Zip: _________________________________________________ phone:________________
Entry Name: ___________________________________________________ Reg. #________________
Sire: _________________________________________________________ Reg. # _______________
Dam: ________________________________________________________Reg. # ________________
Nomination fee is $300 for the Open Division and $200 for the Non Pro Division to be paid by May 31 in their competition year. Late entries are accepted according to schedule below. 100% of nomination fees are jackpotted. (not including late fees).
All entries close when the first reining class enters the pen at Working Western World Championships.
| Nomination Fees | If paid by May 31 | If paid by June 1 | If paid by July 1 | If paid at show |
| Open | $300 | $300 + $50 | $300 + $100 | $300 + $200 |
| Non Pro | $200 | $200 + $50 | $200 + $100 | $200 + $200 |
|
Stallion Owners Who Have Donated a Breeding To This Year’s Derby That Was Sold Use This Form
You may enter one division at half the nomination fee (does not include penalties).
Stallions name:______________________________
Date: _______________________________________
Open Division Nomination Fees Enclosed: $______________
Non Pro Div. Nomination Fees Enclosed: $______________
Tracking Office Fee $ $50
Total Fees Enclosed: $______________ |
|
Regular Entrants & Sire & Dam Offspring Entrants Use This Form
Date: _____________________________________
Open Division Nomination Fees Enclosed: $______________
Non Pro Div. Nomination Fees Enclosed: $______________
Tracking Office Fee $ $50
Total Fees Enclosed: $______________ |
Please make out check to:
NMRHA Derby
and mail with this form to:
Travis Filipek
883 Tipperary Rd
Oregon, WI 53575
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