2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW

Stall reservation form

September 15-26, 2020 – SPRINGFIELD, ILLINOIS

Mail forms to PHBA * 15253 East Skelly Dr * Tulsa, OK 74116-2637 Phone: (918) 438-1234 Fax: (918) 438-1232 Website: www.palominohba.com

Stall Agents Name

Owners Name

Address City State Zip

Home Phone Cell Fax

Email Address

Emergency Contact Information

Hotel Phone Room#

HORSE’S NAME________________________________________________________________________________

(One stall or day stall is required per Horse/World Show Entry)

NO WORLD SHOW REFUNDS * Incomplete entry blanks will not be accepted * US Postmark with US Funds will be used in determining fees.

Arrival Date _______________________________________ Departure Date _____________________________________

HORSES MAY MOVE INTO STALLS ON TUESDAY; SEPTEMBER 15th AT 8 AM

On or before 7/15/2020 On or after 7/16/2020

Youth Stalls (Sept 15-20) $125.00 ea __________ $175.00 ea _________ = $

Youth Tack Stall $125.00 ea __________ $175.00 ea _________ = $

Open/Amateur/Youth Stalls (Sept 15-26) $215.00 ea __________ $265.00 ea _________ = $

Open/Amateur/Youth Tack Stall $215.00 ea __________ $265.00 ea _________ = $

Day Stall $105.00 ea __________ $185.00 ea _________ = $

Total Amount Due = $

Please stall me with:

Complete stall payments MUST accompany stall reservation form. Absolutely no reservations without

payment

Method of Payment: US Funds, Check payable to PHBA Visa * MasterCard * Discover * American Express

(Fees above are discounted for cash or check paying customers)

Credit Card #: _____________________________________________________________ Exp Date: _______________ SEC Code: _____________

Name on Credit Card (Please Print) _________________________________________________________________________________________

Signature of Card Holder: ________________________________________________________________________________________________________

2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW

ENTRY FORM-September 17-26, 2020

Springfield, IL

Mail entries to PHBA * 15253 East Skelly Dr * Tulsa, OK 74116-2637

Phone: (918) 438-1234 Fax: (918) 438-1232 Website: www.palominohba.com

Horse Name

PHBA Registration Number YR Foaled Sex

Owners Name

Owners PHBA# Owners NSBA# Tax Id #

Address City State Zip

Home Phone Cell Fax

Email Address

NO WORLD SHOW REFUNDS * Incomplete entry blanks will not be accepted * US Postmark with US Funds will be used in determining fees.

Class Number Class Name Exhibitor Name PHBA # Class Fee 1 $

2

$

3

$

4

$

5

$

6

$

7

$

8

$

9

$

10 $

11

$

12

$

13

$

14

$

15

$

ENTRY FEES

Administration Fee (one per horse) 1 $105.00 = $105.00

Pattern Book Required to purchase if entered in a patterned class $10.00 = $

Open/Amateur Class Entry Fee (postmarked on or before July 15th) $125.00 ea = $

Open/Amateur Class Entry Fee (postmarked July 16th – August 1st) $220.00 ea = $

Open/Amateur Class Entry Fee (postmarked on or after August 16th-till 5pm day before) $350.00 ea = $

Open/Amateur NSBA Dual Approved Entry Fee $25.00 ea = $

Youth Class Entry Fee (postmarked on or before July 15th) $75.00 ea = $

Youth Class Entry Fee (postmarked July 15th – August 1st) $90.00 ea = $

Youth Class Entry Fee (postmarked on or after August 2nd -till 5pm day before ) $135.00 ea = $

Youth NSBA Dual Approved Class Fee $15.00 ea = $

Amateur Team Tournament Fee (per division) $25.00 = $

APA exhibitor credit (Must submit APA exhibitor credit form with World Show Entry- Excludes Stakes and Futurity classes). Credit Amount =$__________

World Show Entry Total =$______________________

One Stall/Day Stall is required per Horse/World Show Entry - Complete Stall Reservation Form and submit with entry Horses entered by deadline can enter add’t classes by 5:00 PM the day before the class for an extra $25 per class - ALL other requirements must be met. I (we) the owners, exhibitors hereby agree to abide by the PHBA Officia l Rulebook and the WCHS Rules and hereby release PHBA, its off icers, directors and agents from any and all c laims, demands, causes of action and ex pense arising from or related to the WCHS. In the event that the entry form is not signed or presented, appearance on the grounds as an exhibitor, handler, owner, trainer or consignor shall be deemed acceptance of and agreement to th is fu ll and fair re lease.

OWNER, TRAINER OR AGENT’S SIGNATURE (REQUIRED) ___________________________________________________________________________________________________

Method of Payment: US Funds, Check payable to PHBA

*Visa * MasterCard * Discover * American Express (Fees listed are discounted for check/cash paying customers)

Credit Card #: _______________________________________________________ Exp Date: _______________ SEC Code: _____________

Name on Credit Card (Please Print) ____________________________________________________________________________________

Signature of Card Holder: _____________________________________________________________________________________________

CURRENT 12 MONTH NEG. EIA (COGGINS) AND A 30-DAY HEALTH CERTIFICATE MUST BE PRESENT TO SHOW AT THE 2020 PHBA WORLD. ORIGINAL PHBA CERTIFICATE MUST BE PRESENT (PHOTOCOPIES WILL BE ACCEPTED).

2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW

INDIVIDUALS ENTERING THE WORLD SHOW ARE RESPONSIBLE TO OBTAIN A COMPLETE COPY OF THE WORLD CHAMPIONSHIP HORSE SHOW RULES REGARDING

ADDITIONAL RULES AND THE CREDIT POLICY.

US Funds must accompany the entry blank. One entry form per horse. Entries received without funds will not be considered complete. The US postmark on the envelope containing the funds will determine the

appropriate entry fees. Postmarks from the US Post Office are used in determining any and all deadline compliance. If an envelope contains a postal meter mark or tape as well as a US Post Office cancellation,

PHBA will use the US Post Office cancellation as the final decision in determining any and all deadline compliance. Once an entry has been placed in the mail it will be considered a valid entry and the check will not

be held or returned and No Refunds will be allowed. Entries postmarked after the Entry deadline will be accepted under the current Entry deadline fees and will not be refunded.

NO WORLD SHOW REFUNDS FOR ANY REASON - PLEASE READ THE PHBA WORLD SHOW RULES FOR MORE INFORMATION

All Owners, and Exhibitors must be current members to show. All Amateurs, Novice Amateurs, Youth and Novice Youth must fulfill PHBA requirements. Copies of current NSBA membership cards will be required for all NSBA classes for both the Owner(s) and Exhibitor(s). Copies of current NRHA membership cards will be required as well.

All horses must be registered with PHBA in order to show in any class at the PHBA World Show. All horses are subject to PHBA eligibility for registration requirements. If protested, PHBA rules and procedures will be followed. All awards and titles may be revoked.

One Stall is required to be purchased for each horse. Stall/Tack reservations will be honored on a first come first serve basis. Stalls may be purchased for the duration of the show or a day stall may be purchased.

All owners/exhibitors must present to the PHBA Show Office an Original PHBA Certificate of Registration (PHOTOCOPIES WILL BE ACCEPTED), thirty-day (30) health papers and an Original Negative EIA (Coggins) within twelve months (12) of the horse show date to receive their Back numbers. E I A ( Coggins) and Health Certificates must have the horse’s PHBA Registered Name. No barn or nicknames will be allowed. All horses must comply with Illinois Department of Agriculture requirements for entry into Illinois borders. E I A ( Coggins) tests are required for equines weanling age and older.

Pattern Books are required to be purchased if entered in a patterned class. If paying with a credit card you will be charged for the Pattern Book. Pattern Books will be published online and available for purchase at the PHBA World Show.

All classes will be held as offered, regardless of the number of entries.

This additional information must be completed for each exhibitor per horse if additional room is needed photocopies maybe used

HORSE NAME PHBA REGISTRATION#

Open Exhibitors Name PHBA ID #

Address City State Zip

Date of Birth Home Phone# Work#

Cell# Fax# Email Address

List class numbers to entered by this exhibitor

Amateur and/or Novice Exhibitors Name PHBA ID #

Address City State Zip

Relationship to Owner

Date of Birth Home Phone# Work#

Cell# Fax# Email Address

List class numbers to entered by this exhibitor

Youth and/or Novice Exhibitors Name PHBA ID #

Address City ____________ State __________________ Zip_________

Date of Birth _______________________________________________________ List class numbers to entered by this exhibitor _____________________________________________________________________________________________________________

I (we) the owners, exhibitors hereby agree to abide by the PHBA Offic ial Rulebook and the WCHS Rules and hereby release PHBA, i ts off icers, directors and agents from any and all claims, demands, causes of action and expense arising from or related to the WCHS. In the event that the entry f orm is not signed or presented, appearance on the grounds as an exhibitor, handler, owner, trainer or consignor shall be deemed ac ceptance of and agreement to this full and fair release. Presentation of the Entry form shall be deemed acceptance of the conditions of this rule and of the PHBA TV & Media Rule found under the PHBA General Rules. PHBA World Show management endeavors to promptly announce event results and present awards and titles. However, should it come to the attention of the management that a clerical error affecting a placing and/or title, such error will be reviewed, corrected and officially confirmed by the show management. Any title and/or award that should be presented due to such error are to be returned to PHBA by the recipient immediately upon notification of the corrected error. If tabulation error is suspected, a written inquiry shall be presented to the show office within 24 hours after the completion of the affected class without using the protest procedure. All inquiries must be given before the final Golden Horse award presentation or they shall be deemed waived. PHBA reserves the right to correct such an error without recourse from entrants and revoke any award at any time. After judgment all awards are to be returned to the show office or show secretary as directed within 24 hours of receipt of notice to return. ENTRIES MAY BE CHECKED ONLINE AT WWW.PALOMINOHBA.COM FOR CORRECTNESS. IF NOT ALREADY CURRENT, PLEASE INCLUDE MEMBERSHIP DUES ALONG WITH YOUR ENTRY, OWNERS(S) AND EXHIBITOR(S) MUST BE CURRENT MEMBERS IN GOOD STANDING OF PHBA TO COMPETE AT THE WORLD.

PARENT, OWNER, TRAINER OR AGENT'S SIGNATURE (REQUIRED)

IF PAYING WITH CREDIT CARD AND ENTERED IN CLASSES 990-998 YOUR PAYMENTS WILL AUTOMATICALLY BE CHARGED WHEN THAT PAYMENT IS DUE UNLESS WE ARE NOTIFIED PRIOR TO THE DEADLINE DATE OF (JULY 15th AND AUGUST 15th) CREDIT CARD ORDERS PLEASE COMPLETE INFORMATION BELOW – The fees listed are the discounted price for cash and check paying customers.

TOTAL AMOUNT FOR THIS ENTRY $_______________

BY SUMITTING THIS ENTRY BLANK, IF TOTAL AMOUNT IS NOT CALCULATED CORRECTLY, YOU AUTHORIZE PHBA TO CHARGE THE APPROPRIATE FEES.

I (we) would like to offer the following PHBA Approved Judge names for consideration to judge the 2021 PHBA World Show. Understanding that this is merely an offering and that these names will be forwarded to the appropriate committee for further consideration.

______________________________________________________________________________________________________________________________________

CURRENT 12 MONTH NEG. EIA (COGGINS) AND A 30 DAY HEALTH CERTIFICATE MUST BE PRESENT TO SHOW AT THE 2020 PHBA WORLD. ORIGINAL PHBA CERTIFCATE MUST BE PRESENT (PHOTOCOPIES WILL BE ACCECPTED).

2020 PHBA WORLD championship horse show OPEN/AMATEUR class numbers

2 Weanling Stallions 3 Yearling Stallions 4 Two YO Stallions 5 Three YO Stallions 7 Aged Stallions 228 Performance Halter Stallions 500386 NSBA Perf. Halter Stallions 410 PB Stallions 11 Weanling Mares 12 Yearling Mares 13 Two YO Mares 14 Three YO Mares 16 Aged Mares 229 Performance Halter Mares 500384 NSBA Perf. Halter Mares 420 PB Mares 21 Weanling Geldings 22 Yearling Geldings 23 Two YO Geldings 24 Three YO Geldings 26 Aged Geldings 230 Performance Halter Geldings 500385 NSBA Perf. Halter Geldings 430 PB Geldings 31 Color All Ages 41 Junior Western Pleasure 510301 NSBA Jr Western Pleasure 42 Senior Western Pleasure 510302 NSBA Sr Western Pleasure 440 PB Open Western Pleasure 44009 NSBA PB Open Western Pl 61 Junior Trail 530301 NSBA Junior Trail 62 Senior Trail 530302 NSBA Senior Trail 460 PB Open Trail 46009 NSBA PB Open Trail 70 Western Riding All Ages 540300 NSBA Western Riding 76 Open Flag Race 476 PB Flag Race 80 Ranch Horse All Aged 83 Ranch Riding All Aged 549300 NSBA Ranch Riding 90 Open Reining 1100 NRHA Open Reining 300 Open Ranch Rail Pleasure 519300 NSBA Open Ranch Rail Pl 121 Open Pole Bending 521 PB Pole Bending 131 Junior Hunter Saddle 520301 NSBA Jr Hunter Under Saddle 132 Senior Hunter Under Saddle 520302 NSBA Sr Hunter Under Saddle 530 PB Hunter Under Saddle 53009 NSBA PB HunterUnderSaddle 135 Junior Barrel Racing 136 Senior Barrel Racing 520 PB Open Barrel Racing 141 Junior Road Hack 142 Senior Road Hack 150 Open Pleasure Driving 599300 NSBA Open Pleasure Driving 232 Hunter In Hand 520380 NSBA Hunter In Hand 239 Open Ranch Conformation 303 Open Ranch Reining 306 Open Ranch Trail 539300 NSBA Open Ranch Trail 470 PB Open Western Riding

47009 NSBA PB Western Riding 3400 A Western Horsemanship 555600 NSBA A W Horsemanship 3500 PB A W Horsemanship 35009 NSBA PB A W Horsemanship 3406 A Ranch Horse 3407 A Barrel Racing 3507 PB A Barrel Racing 3408 A Pole Bending 3508 PB A Pole Bending 3410 A Hunt Seat Equitation 565600 NSBA A Hunt Seat Equitation 3510 PB A Hunt Seat Equitation 35109 NSBA PB A Hunt Seat Equit 3415 A Pleasure Driving 599600 NSBA A Pleasure Driving 3416 A Stake Race 3516 PB A Stake Race 3420 A Hunter Under Saddle 525600 NSBA A Hunter Under Saddle 3520 PB A Hunter Under Saddle 35209 NSBA PB A HUS 3430 A Road Hack 3445 A Color 3450 A Western Pleasure 515600 NSBA A Western Pleasure 3550 PB A Western Pleasure 35509 NSBA PB A Western Pleasure 3451 A Weanling Stallions 3452 A Yearling Stallions 3453 A Two YO Stallions 3454 A Three YO Stallions 3456 A Aged Stallions 3441 A Performance Halter Stallions 500686 NSBA A Perf. Halter Stallions 3532 PB A Stallions 3461 A Weanling Mares 3462 A Yearling Mares 3463 A Two YO Mares 3464 A Three YO Mares 3466 A Aged Mares 3442 A Performance Halter Mares 500684 NSBA A Perf. Halter Mares 3535 PB A Mares 3471 A Weanling Geldings 3472 A Yearling Geldings 3473 A Two YO Geldings 3474 A Three YO Geldings 3476 A Aged Geldings 3443 A Performance Halter Geldings 500685 NSBA A Perf. Halter Geldings 3538 PB A Geldings 3459 A Flag Race 3559 PB A Flag Race 3460 A Trail 535600 NSBA A Trail 3560 PB A Trail 35609 NSBA PB A Trail 3470 A Western Riding 545600 NSBA A Western Riding 3570 PB A Western Riding 35709 NSBA PB A Western Riding 3480 A Reining 1400 NRHA Non Pro Reining 3482 A Ranch Reining 3490 A Showmanship 505600 NSBA A Showmanship 3590 PB A Showmanship 35909 NSBA PB A Showmanship 3483 A Ranch Trail

539608 NSBA A Ranch Trail 3494 A Ranch Riding 549600 NSBA A Ranch Riding 3505 A Ranch Conformation 3504 A Hunter In Hand 3495 A Ranch Rail Pleasure 519600 NSBA A Ranch Rail 3600 A Select W Horsemanship 556606 NSBA A S W Horsemanship 3610 A Select Hunt Seat Equitation 566406 NSBA A S Hunt Seat Equit 3618 A Select Ranch Riding 549606 NSBA A Select Ranch Riding 3619 A Select Ranch Rail Pleasure 519006 NSBA A Select Ranch Rail Pl 3620 A Select Hunter Under Saddle 526600 NSBA A Select HUS 3630 A Select Road Hack 3650 A Select Western Pleasure 516606 NSBA A Select WP 3660 A Select Trail 536606 NSBA A Select Trail 3661 A Select Ranch Trail 539606 NSBA A Select Ranch Trail 3681 A Select Ranch Reining 3690 A Select Showmanship 506606 NSBA A Select Showmanship 4313 Nov Hunter Under Saddle 525400 NSBA Nov HunterUnderSaddle 4223 Nov Western Horsemanship 555400 NSBA Nov W Horsemanship 4224 Nov Hunt Seat Equitation 565400 NSBA Nov Hunt Seat Equit 4253 Nov Trail 535400 NSBA Nov Trail 4270 Nov Ranch Riding 549400 NSBA Nov Ranch Riding 4271 Nov Ranch Rail Pleasure 519400 NSBA Nov Ranch Rail Pl 4272 Nov Ranch Reining 4273 Nov Ranch Trail 539408 NSBA Nov Ranch Trail 4447 Nov Western Pleasure 515408 NSBA Nov Western Pleasure 4491 Nov Showmanship

505400 NSBA Nov Showmanship 3808 A Walk Trot Hunt Seat Equit 565060 NSBA A WT Hunt Seat Equit 3807 A Walk Trot HUS 525060 NSBA A Walk Trot HUS 3809 A Walk Trot Trail 535060 NSBA A Walk Trot Trail 3806 A Walk Trot W Horsemanship 555060 NSBA A WT W Horsemanship 3810 A Walk Trot Western Pleasure 515060 NSBA A WT Western Pleasure 3805 A Walk Trot Showmanship 505060 NSBA A WT Showmanship

CURRENT 12 MONTH NEG. EIA (COGGINS) AND A 30 DAY HEALTH CERTIFICATE MUST BE PRESENT TO SHOW AT THE 2020 PHBA WORLD. ORIGINAL PHBA CERTIFCATE MUST BE PRESENT (PHOTOCOPIES WILL BE ACCECPTED)

2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW Youth class numbers

Youth 6 & Under 501— Costume Stick Horse class $25.00 Proceeds to PHBA Youth Scholarship & Educational Fund 1151— Leadline 3-8 Novice Youth 18 & Under 1610—Nov Showmanship** 507100 – NSBA Nov Showmanship 1620—Nov Western Horsemanship** 557100 – NSBA Nov Western Horsemanship 1630—Nov Hunt Seat Equitation** 567100 – NSBA Nov Hunt Seat Equitation 1640—Nov Western Pleasure** 517100-NSBA Nov Western Pleasure 1650—Nov Trail** 507100--NSBA Nov Trail 1710—Nov Hunter Under Saddle** 527100--NSBA Nov Hunter Under Saddle 1760 – Nov Ranch Riding** 549103 - NSBA Nov Ranch Riding 1763 – Nov Ranch Trail** 539710 – NBSA Nov Ranch Trail Youth Walk Trot 1101-W/T 5-9 Showmanship** 507061 – NSBA W/T 5-9 Showmanship 1102-W/T 5-9 Western Horsemanship** 557061 – NSBA W/T 5-9 Western Horsemanship 1103-W/T 5-9 Hunter Under Saddle** 527061 – NSBA W/T 5-9 Hunter Under Saddle 1104-W/T 5-9 Hunt Seat Equitation** 567061 – NSBA W/T 5-9 Hunt Seat Equitation 1105-W/T 10-18 Showmanship** 507060 – NSBA W/T 10-18 Showmanship 1106–W/T 10-18 Western Horsemanship** 557060 – NSBA W/T 10-18 Western Horsemanship 1107-W/T 10-18 Hunter Under Saddle** 527060 – NSBA W/T 10-18 Hunter Under Saddle 1108-W/T 10-18 Hunt Seat Equitation** 567060 – NSBA W/T 10-18 Hunt Seat Equitation 1109-W/T 10-18 Trail 537060 – NSBA 10-18 Trail 1110-W/T 10-18 Western Pleasure** 517060 – NSBA W/T 10-18 Western Pleasure 1150-W/T 5-9 Trail** 537061 – NSBA W/T 5-9 Trail 1199-W/T 5-9 Western Pleasure** 517061 – NSBA W/T 5-9 Western Pleasure Youth 13 & Under 1211—Showmanship at Halter** 507302 – NSBA Showmanship at Halter 1221—Western Horsemanship** 557302 – NSBA Western Horsemanship 1228—Flag Race 1231—Hunt Seat Equitation** 567302 – NSBA Hunt Seat Equitation 1241—Western Pleasure** 517302--NSBA Western Pleasure 1251—Trail** 537302--NSBA Trail 1301—Barrel Racing 1306—Pole Bending 1311—Hunter Under Saddle** 527302--NSBA Hunter Under Saddle 1321—Road Hack 1357—Stake Race Youth 14 Thru 18 1212—Showmanship at Halter**

507303 – NSBA Showmanship at Halter 1222—Western Horsemanship** 557303 – NSBA Western Horsemanship 1229—Flag Race 1232—Hunt Seat Equitation** 567303--NSBA Hunt Seat Equitation 1242—Western Pleasure** 517303--NSBA Western Pleasure 1252—Trail** 537303--NSBA Trail 1302—Barrel Racing 1307—Pole Bending 1312—Hunter Under Saddle** 527303--NSBA Hunter Under Saddle 1322—Road Hack 1358—Stake Race Youth 18 & Under 1361—Yearling Mares 1362—Two-Year Old Mares 1363—Three-Year Old Mares 1365—Aged Mares 1367—Yearling Geldings 1368—Two-Year Old Geldings 1369—Three-Year Old Geldings 1371—Aged Geldings 1208—Color 1413 - Performance Halter Mares** 507384 - NSBA Performance Halter Mares 1405 – Hunter In Hand (All Mares and Geldings) 1414-Performace Halter Geldings** 507385 - NSBA Performance Halter Geldings 1260 – Western Riding** 547300 – NSBA Western Riding 1270 - Ranch Horse 1280 - Reining 1380 - Ranch Riding** 549103 - NSBA Ranch Riding 1381 – Ranch Reining 1384 – Ranch Trail** 539700 – NSBA Ranch Trail 1253 – Ranch Rail Pleasure** 519700 – NSBA Ranch Rail Pleasure 1416 - Ranch Conformation Palomino Bred 18 & Under 1801 - PB Mares 1804- PB Geldings 1840 – PB Western Pleasure** 18409 – NSBA PB Western Pleasure 1910 – PB Hunter Under Saddle** 19109 – NSBA PB Hunter Under Saddle 1850 – PB Trail** 18509 – NSBA PB Trail 1810 – PB Showmanship** 18109 – NSBA PB Showmanship 1820 – PB Western Horsemanship** 18209 – NSBA PB Western Horsemanship 1827 – PB Flag Race 1830 – PB Hunt Seat Equitation** 18309 – NSBA PB Hunt Seat Equitation 1860 – PB Western Riding** 18609-NSBA PB Western Riding 1900 – PB Barrel Racing 1905 – PB Pole Bending 1956 – PB Stake Race

2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW

NSBA/PHBA ENTRY FORM – September 17-26, 2020

Mail entries to PHBA * 15253 East Skelly Dr * Tulsa, OK 74116-2637 Phone: (918) 438-1234 Fax: (918) 438-1232 Website: www.palominohba.com

Horse Name

PHBA Registration Number YR Foaled Sex

Owners Name

Owners PHBA# Owners NSBA# Owners Tax Id #

Address City State Zip

Home Phone Cell

Email Address __________________________________________________________________________________________

Horse’s NSBA Certificate of Eligibility Number-COE #L

*Classes 991, 992, 994 and 996 are open to both Palomino and Palomino Bred registered horses.

Classes 990-998 are 2 payment classes postmarked by the dates below. Entries postmarked after dates will be accepted but will be doubled.

July 15th August 15th $100.00 $200.00

Class # Class Name PHBA # NSBA #

990 PHBA/NSBA 2 Year-Old Snaffle Bit Western Pleasure Futurity

Exhibitor’s Name

*991 PHBA/NSBA 3 Year-Old Snaffle Bit Western Pleasure Derby

Exhibitor’s Name

*992 PHBA/NSBA 4 Year-Old & Older Western Pleasure Maturity

Exhibitor’s Name

993 PHBA/NSBA Yearling Longe Line

Exhibitor’s Name

*994 PHBA/NSBA All Ages Hunter Under Saddle Stakes

Exhibitor’s Name

995 PHBA/NSBA Amateur Yearling Longe Line

Exhibitor’s Name

*996 PHBA/NSBA Non-Pro Western Pleasure Stakes

Exhibitor’s Name

997 PB/NSBA Open Yearling Longe Line

Exhibitor’s Name

998 PB/NSBA 2 Year-Old Snaffle Bit Western Pleasure Futurity

Exhibitor’s Name

Administration Fee (one per horse) - Due only when horse is not already entered in a PHBA World Show Class 1 $105.00

One Stall/Day Stall is required per Horse/World Show Entry – Complete Stall Reservation Form and submit with entry if not already done

Total due for this entry = $

NO WORLD SHOW REFUNDS * Incomplete entry blanks will not be accepted * US Postmark with US Funds will be used in determining fees. I (we) the owners, exhibitors hereby agree to abide by the PHBA Official Rulebook and the WCHS Rules and hereby release PHBA, its off icers, directors and agents from any and all claims, demands, causes of action and expense arising from or related to the WCHS. In the event that the entry f orm is not signed or presented, appearance on the grounds as an exhibitor, handler, owner, trainer or consignor shall be deemed acceptance of and agreemen t to this full and fair release.

OWNER, TRAINER OR AGENT’S SIGNATURE (REQUIRED) ___________________________________________________________________________________

Method of Payment: US Funds, Check payable to PHBA * Visa * MasterCard * Discover * American Express (The fees listed are the discounted price for cash and check paying customers)

Credit Card #: _______________________________________________________ Exp Date: _______________ SEC Code: _____________

Name on Credit Card (Please Print) ____________________________________________________________________________________

Signature of Card Holder: _____________________________________________________________________________________________

IF PAYING WITH CREDIT CARD AND ENTERED IN CLASSES 990-998 YOUR PAYMENTS WILL AUTOMATICALLY BE CHARGED WHEN THAT PAYMENT IS DUE UNLESS WE ARE NOTIFIED PRIOR TO THE DEADLINE DATE OF (JULY 15th, AND AUGUST 15th).

CURRENT 12 MONTH NEG. EIA (COGGINS) AND A 30 DAY HEALTH CERTIFICATE MUST BE PRESENT TO SHOW AT THE 2020

PHBA WORLD. ORIGINAL PHBA CERTIFICATE MUST BE PRESENT (PHOTOCIPIES WILL BE ACCECPTED).

2020 PHBA WORLD CHAMPIONSHIP HORSE SHOW

CHALLENGED HORSEMAN ENTRY FORM

September 17-26, 2020 – SPRINGFIELD, ILLINOIS Mail entries to PHBA * 15253 East Skelly Dr * Tulsa, OK 74116-2637

Phone: (918) 438-1234 Fax: (918) 438-1232 Website: www.palominohba.com

PLEASE POSTMARK OR FAX ENTRY FORM ON OR BEFORE AUGUST 1 - ONE FORM PER EXHIBITOR

Horse’s Name Horses Registration Number

Exhibitor’s Name PHBA Membership Id # (if member)

Exhibitor’s Address City State Zip

Exhibitor’s Phone Fax Email

Owner’s Name Owner’s PHBA Id # (if member)

Owner’s Address City State Zip

Owner’s Phone Work # Cell #

Fax # Email

THERE IS NO ENTRY FEE FOR THESE CLASSES

I (WE) HEREBY CERTIFY THAT EVERY HORSE AND EXHIBITOR IS ELIGIBLE AS ENTERED AND AGREE THAT THE OWNER AND ANY OF HIS REPRESENTATIVES, AGENTS, TRAINERS, LESSEE, RIDER, HANDLER, DRIVER AND THE HORSE SHALL BE SUBJECT TO AND BOUND BY THE BY-LAWS AND RULES OF THE PALOMINO HORSE BREEDERS OF AMERICA, INC AND THE RULES OF THE PALOMINO CHAMPIONSHIP WORLD SHOW. PRESENTATION OF THE ENTRY FORM SHALL BE DEEMED ACCEPTANCE OF THE CONDITIONS OF THE RULES AND OF THE PHBA & TV MEDIA RULE FOUND UNDER THE PHBA GENERAL RULES. IN THE EVENT AN ENTRY FORM IS NOT SIGNED OR PRESENTED, APPEARANCE OF THE GROUNDS AS AN EXHIBITOR, HANDLER, OWNER OR CONSIGNOR SHALL BE DEEMED ACCEPTANCE OF THE RULES. I WILL FURNISH A 30-DAY HEALTH CERTIFICATE AND A 12 MONTH NEGATIVE COGGINS FOR EACH HORSE ENTERED IN THE SHOW. I ASSUME ALL LIABILITY AND RESPONSIBILITY FOR ANY ACCIDENTS, INJURY OR DAMAGES SUSTAINED OR CAUSED BY MYSELF, MY HELPERS, MY STOCK/EQUIPMENT, AND AGREE TO INDEMNIFY AND HOLD HARMLESS THE SPONSORS OF THE SHOW, THE OWNER OF THE GROUNDS IN USE AND THEIR REPRESENTATIVES AND EMPLOYEES. I (we) the owners, exhibitors hereby agree to abide by the PHBA Off icial Rulebook and the WCHS Rules and hereby release PHBA, i ts officers, d irectors and agents from any and all c laims, demands, causes of action and expense arising from or related to the WCHS. In the event that the entry form is not signed or presented, appearance on the grounds as an exhibitor, handler, owner, trainer or consignor shall be deemed acceptance of and agreement to th is fu ll and fair re lease.

Signature of Owner, Parent or Guardian

Please circle the class (es), above named exhibitor will be entering CLASS # CLASS# 5000 Assisted Challenged Horseman Lead In 5009 Unassisted Challenged Horseman W/T/L Hunter Under Saddle 5006 Assisted Challenged Horseman Trail 5003 *Unassisted Challenged Horseman W/T Trail 5005 *Unassisted Challenged Horseman W/T Showmanship 5013 Unassisted Challenged Horseman W/T/L Trail 5008 Unassisted Challenged Horseman W/T/L Showmanship 5001 *Unassisted Challenged Horseman W/T Western 5004 *Unassisted Challenged Horseman W/T Hunt Seat Equitation 5011 Unassisted Challenged Horseman W/T/L Western 5010 Unassisted Challenged Horseman W/T/L Hunt Seat Equitation 5002 *Unassisted Challenged Horseman W/T Western Horsemanship 5007 *Unassisted Challenged Horseman W/T Hunter Under Saddle 5012 Unassisted Challenged Horseman W/T/L Western Horsemanship

NSBA Dual Approved* Class (es), each class requires a $3 entry fee (owner and exhibitors must be NSBA members)

50019 NSBA Unassisted Challenged Horseman W/T Western Owners NSBA Id # Riders NSBA Id #

50029 NSBA Unassisted Challenged Horseman W/T Western Horsemanship Owners NSBA Id # Riders NSBA Id #

50049 NSBA Unassisted Challenged Horseman W/T Hunt Seat Equitation Owners NSBA Id # Riders NSBA Id #

50079 NSBA Unassisted Challenged Horseman W/T Hunter Under Saddle Owners NSBA Id # Riders NSBA Id #

50059 NSBA Unassisted Challenged Horseman W/T Showmanship Owners NSBA Id # Riders NSBA Id #

50039 NSBA Unassisted Challenged Horseman W/T Trail Owners NSBA Id # Riders NSBA Id #

CHALLENGED HORSEMAN RULES AND GUIDELINES:

Open to challenged riders of any age.

Open to all breeds of horses.

Horses do not have to be registered with the PHBA or any other breed registry.

All horses must have a current 12-month negative Coggins, 30-day health certificate.

Owners/Exhibitors must report to the stalling office upon arriving to the Horse show to have their health papers and coggins papers checked. At that time

they will be given paperwork to present to the show office to receive the official back number that will be given to the Exhibitor to wear into the arena while

exhibiting their horse.

There are no entry fees for these classes. Exception: NSBA Dual Approved Classes

Attire should be as described in the Challenged Horseman Rules in the PHBA Handbook.

Protective headgear is optional, but recommended by PHBA. The adult handler does not have to wear matching attire or headgear.

Each exhibitor must complete and return the Special Diagnosis Form to the PHBA office prior to showing in a Challenged Horseman’s class.

PLEASE SEE PHBA HANDBOOK FOR COMPLETE CHALLENGED HORSEMAN'S RULES AND GUIDELINES

WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT - Oklahoma

READ CAREFULLY BEFORE SIGNING

I agree to this agreement with PHBA, its officers, directors, employees and agents who is/are (check QM. only) = an individual(s) D a corporation or LLC (hereafter referred to as "PHBA") as a condition for his/her/its/their allowing me and the persons identified below (if any), to do any or all of the following at any time and at any location: enter PHBA's premises, land, facilities, barns, arenas, paddocks, pastures, and surrounding land; be near horses, ponies, mules, or donkeys (hereafter, "equines"), work with, handle, ride, drive, and/or receive instruction or guidance related to riding, driving, handling and/or working with equines. (All of these activities, individually and collectively, will be referred to as "The Activities" throughout this document.)

NA.ME (Please print clearly): _________________________ _

NAME OF OTHER CONTRACTING PARTY (Spouse or Other Parent): ___________ _

ADDRESS: ___________________________ _

PHONE: [Home] ______ [Work] _______ ___ [Cell/Other] _____ __

To the fullest extent allowed by law, I also make this agreement on behalf of the following who is/are my child/children or legal ward(s):

l. ___________ AGE: 2. ___ _________ AGE: __Date of Birth: Date of Birth:

--------- ----------

All parts of this document apply to me and each of the children or legal wards listed above. [We will collectively call ourselves "I," "me," or "my" throughout this document.]

IT IS AGREED AS FOLLOWS:

1. Consideration. I have voluntarily requested to engage in any or all of The Activities and I am signing this document inconsideration for being allowed to engage in any or all of The Activities now and in the future. I understand that although I am signing thisdocument today, I intend for it to be valid and binding when I engage in any or all of The Activities at any time in the future at any location.2. Risks of Livestock and Equine Activities. understand that these are just some of the risks, and I agree to assume othersthat are not mentioned in this document. I am NOT relying on PHBA to list all possible equine-related risks in this document orany time, now or in the future.I understand that anyone riding, driving, handling, working with, or even near an equine at any location can suffer bodily and other injuries. Among other things, equines are unpredictable by nature. For example, when frightened, angry, or under stress, the natural instincts of an equine are to jump forward or sideways, back up quickly, or run away from real or perceived danger by trotting or galloping. Equines also have the ability to kick, buck, rear up, spin around, strike, or bite. I know that equines can do these and other things without warning. I also understand that all equines, even if they have no history of hurting anyone, are powerful and have the potential to be dangerous to people, equines, and other animals. I also understand that riding, driving, handling, working with, or even being near equines/livestock can expose me to those dangers or conditions which are an integral part of livestock activities, including but not limited to: (a) the propensity of livestock to behave in ways that may result in injury to persons on or around them; (b) the unpredictability of livestock's reaction to such things as sounds, sudden movement and unfamiliar objects, persons or other animals; (c) certain hazards such as surface and subsurface conditions unknown to the livestock activity sponsor; (d) collisions with other livestock or objects; and (e) the potential of tack to become dislodged or move in ways that may result in injury to persons on or around livestock activities. / understand these risks

and dangers that are inherent in equine and livestock-related activities, and I agree to assu,ne all of them. I also INITIAL HERE: ___ 3. WAIVER OF LIABILITY/EXPRESS ASSUMPTION OF RISK: As lawful considerationfor being allowed to engage in any or all of The Activities, now and in the future and at any location, I (on hehalfofmyselfandmy spouse, parents, heirs representatives, assigns, minor child/ren or legal wards) agree to each of the following· (a} PHBA and

his/her/its/their respective officers, directors, members, managers, employees, agents, heirs, family members, assigns, representatives, affiliated persons, and others acting on their behalf (hereafter referred to collectively as "The Released Parties") shall not he Hable for any losses, injuries, or damages that I (which includes the signer and signer's minor child/children or legal wards) may sustain as a result of engaging in any of The Activities at any time or at any location; and (b) I/we fully and foreverrelease, waive, and discharge all claims, demands, damages, legal actions, causes of action, or rights of action (present or future} against The Released Parties whether the claims are known, unknown, anticipated or unanticipated, and whether caused by their ordinary negligence, a violation of a state Livestock Activities Liability Limitation Act, or other legal liability resulting from or arising out of my/our engaging in The Activities at any time and at any location. The term "damages" means, for example, medical expenses any and all claims or losses because of bodily injuries, mental/emotional injuries, or property damages, death,

Assumption of Risk and Waiver of Liability relating to

Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health

Organization. COVID-19 is extremely contagious and is believe to spread mainly from person-to-person

contact. As a results, state and local governments and federal and state health agencies recommend social

distancing and have, in many locations, prohibited the congregation of groups of people.

Palomino Horse Breeders of America (“the Association”) has put in place preventative measures to

reduce the spread of COVID-19; however the Association cannot guarantee that you or your minor

child(ren) will not become infected with COVID-19. Further, attending the PHBA World Championship

Show could increase your risk and your minor child(ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily

assume the risk that my minor child(ren) and I may be exposed to or infected by COVID-19 by attending

the PHBA World Championship Show and that such exposure or infection may result in personal injury,

illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by

COVID-19 at the PHBA World Championship Show may result from the actions, omissions, or negligence

of myself and others, including, but not limited to, Associations employees, volunteers, and other

attendees and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury

to my minor child(ren) or myself including, but not limited to, personal injury, disability, and death, illness,

damage, loss, claim, liability, or expense of any kind that I or my minor child(ren) may experience or incur

in connection with my minor child(ren)’s attending at the PHBA World Championship Show or

participation at the PHBA World Championship Show (”Claims”). On my behalf, and on behalf of my minor

children, I release, covenant not to sue, discharge, and hold harmless the Association and the Illinois State

Fairgrounds and/or their directors, officers, employees, agents, and representatives, of and from the

Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or

relating thereto. I understand and agree that this release includes any Claims based on the actions,

omissions, or negligence of the Association and the Illinois State Fairgrounds, and/or their directors,

officers, employees, agents and representatives, whether a COVID-19 infection occurs before, during or

after participation at the PHBA World Championship Show or event held at the World Show.

Signature of Parent/Guardian Date

Print Name of Parent/Guardian Names of Participant(s)