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TEAM ENTRY FORM2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
Entry Deadline: MARCH 15, 2016
Please note that any and all information may be used in press releases and promotional materials for the 2016 AjPHA Youth World Games and/or the Paint Horse Journal.
SECTION 1: TEAM INFORMATION
Country Represented: ___________________________ Supported by Regional Club/s: ___________________________
Coach Name: __________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Email: _______________________________________________
Address: ______________________________________ Country: _____________________________________________
City: _________________________________________ State: _______________________________ Zip: ____________
*Please include a headshot photograph of coach.
As the coach of a team in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/
AjPHA and the AjPHA Youth World Games. I have been a member in good standing of the APHA and I am a citizen of the
country I am representing.
_____________________________________________ _____________________Signature of Coach Date
Complete application thoroughly and submit using one of the methods listed at the right.
APPLICATION FEE: $100.00 PER TEAM (Make checks payable to APHA)
Credit Card: r Visa r Mastercard r Discover r Amex
Card Number: _________ – _________ – _________ – _________
CCV: ____________ Exp. Date: _________________
Signature: ______________________________________________
Submit or mail application:
Email: [email protected]
Fax: 817.222.8489
Mail: APHA c/o Christine Henry P.O. Box 961023 Fort Worth, TX 76161
If mailed, application must be postmarked by March 15,2016.
SECTION 2: TEAM MEMBERS’ INFORMATION + AGREEMENT
*Please fill out completely for each exhibitor
Horsemanship Exhibitor
*Please include a headshot photograph for each team member.
Name: _______________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Birthday : _______/ _______/ ________ Age: _____________
Address: ______________________________________ Email: _______________________________________________
City: _________________________________________ Country: _____________________________________________
State: __________ Zip: _______________________
AjPHA Code of Conduct
• As an AjPHA member, I will be honest, fair and friendly.
• I will have respect for myself and others, as well as respect for authority.
• I will be helpful, caring and considerate to others. I understand that I am responsible for what I say and do.
• I will refrain from bullying any person.
• I understand that I am subject to disciplinary action if I am found guilty of unsportsmanlike conduct, including but not limited
to: verbal, physical, written or cyber abuse; threat or actual destruction of property; slander; illegal drug, underage drinking or
tobacco use. I am responsible for my actions.
I, _______________________________________, understand and agree to follow and promote the AjPHA Code
of Conduct. I understand that I am subject to disciplinary action if I am found to have violated APHA’s rules regarding
unsportsmanlike conduct. I understand that I am subject to disciplinary action if I am found to have participated in verbal,
physical, written or cyber abuse or bullying; threatening to destroy or actual destruction of property; libel or slander; illegal
drug use, underage drinking or tobacco use. I understand that I am subject to disciplinary action if I am found to have broken
the law. I understand that I may be subject to disciplinary action if I choose to conduct myself in a manner that is inconsistent
with the rules, objectives and ideals of the American Paint Horse Association.
Participant Agreement
As a participant in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/AjPHA and
the AjPHA Youth World Games. I understand I will be governed and supervised by my Coach/Chaperone, APHA Director of
Youth Activities and any other APHA staff during my participation at the AjPHA Youth World Games. I have been a member in
good standing of the AjPHA and I am a citizen of the country I am representing.
_____________________________________________ _____________________Signature of Exhibitor Date
_____________________________________________ _____________________Signature of Parent or Legal Guardian Date
Month Day Year
SECTION 2: TEAM MEMBERS’ INFORMATION + AGREEMENT (CONTINUED)
Hunt Seat Equitation Exhibitor
*Please include a headshot photograph for each team member.
Name: _______________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Birthday : _______/ _______/ ________ Age: _____________
Address: ______________________________________ Email: _______________________________________________
City: _________________________________________ Country: _____________________________________________
State: __________ Zip: _______________________
AjPHA Code of Conduct
• As an AjPHA member, I will be honest, fair and friendly.
• I will have respect for myself and others, as well as respect for authority.
• I will be helpful, caring and considerate to others. I understand that I am responsible for what I say and do.
• I will refrain from bullying any person.
• I understand that I am subject to disciplinary action if I am found guilty of unsportsmanlike conduct, including but not limited
to: verbal, physical, written or cyber abuse; threat or actual destruction of property; slander; illegal drug, underage drinking or
tobacco use. I am responsible for my actions.
I, _______________________________________, understand and agree to follow and promote the AjPHA Code
of Conduct. I understand that I am subject to disciplinary action if I am found to have violated APHA’s rules regarding
unsportsmanlike conduct. I understand that I am subject to disciplinary action if I am found to have participated in verbal,
physical, written or cyber abuse or bullying; threatening to destroy or actual destruction of property; libel or slander; illegal
drug use, underage drinking or tobacco use. I understand that I am subject to disciplinary action if I am found to have broken
the law. I understand that I may be subject to disciplinary action if I choose to conduct myself in a manner that is inconsistent
with the rules, objectives and ideals of the American Paint Horse Association.
Participant Agreement
As a participant in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/AjPHA and
the AjPHA Youth World Games. I understand I will be governed and supervised by my Coach/Chaperone, APHA Director of
Youth Activities and any other APHA staff during my participation at the AjPHA Youth World Games. I have been a member in
good standing of the AjPHA and I am a citizen of the country I am representing.
_____________________________________________ _____________________Signature of Exhibitor Date
_____________________________________________ _____________________Signature of Parent or Legal Guardian Date
SECTION 2: TEAM MEMBERS’ INFORMATION + AGREEMENT (CONTINUED)
Trail Exhibitor
*Please include a headshot photograph for each team member.
Name: _______________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Birthday : _______/ _______/ ________ Age: _____________
Address: ______________________________________ Email: _______________________________________________
City: _________________________________________ Country: _____________________________________________
State: __________ Zip: _______________________
AjPHA Code of Conduct
• As an AjPHA member, I will be honest, fair and friendly.
• I will have respect for myself and others, as well as respect for authority.
• I will be helpful, caring and considerate to others. I understand that I am responsible for what I say and do.
• I will refrain from bullying any person.
• I understand that I am subject to disciplinary action if I am found guilty of unsportsmanlike conduct, including but not limited
to: verbal, physical, written or cyber abuse; threat or actual destruction of property; slander; illegal drug, underage drinking or
tobacco use. I am responsible for my actions.
I, _______________________________________, understand and agree to follow and promote the AjPHA Code
of Conduct. I understand that I am subject to disciplinary action if I am found to have violated APHA’s rules regarding
unsportsmanlike conduct. I understand that I am subject to disciplinary action if I am found to have participated in verbal,
physical, written or cyber abuse or bullying; threatening to destroy or actual destruction of property; libel or slander; illegal
drug use, underage drinking or tobacco use. I understand that I am subject to disciplinary action if I am found to have broken
the law. I understand that I may be subject to disciplinary action if I choose to conduct myself in a manner that is inconsistent
with the rules, objectives and ideals of the American Paint Horse Association.
Participant Agreement
As a participant in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/AjPHA and
the AjPHA Youth World Games. I understand I will be governed and supervised by my Coach/Chaperone, APHA Director of
Youth Activities and any other APHA staff during my participation at the AjPHA Youth World Games. I have been a member in
good standing of the AjPHA and I am a citizen of the country I am representing.
_____________________________________________ _____________________Signature of Exhibitor Date
_____________________________________________ _____________________Signature of Parent or Legal Guardian Date
SECTION 2: TEAM MEMBERS’ INFORMATION + AGREEMENT (CONTINUED)
Showmanship Exhibitor*Please include a headshot photograph for each team member.
Name: _______________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Birthday : _______/ _______/ ________ Age: _____________
Address: ______________________________________ Email: _______________________________________________
City: _________________________________________ Country: _____________________________________________
State: __________ Zip: _______________________
AjPHA Code of Conduct
• As an AjPHA member, I will be honest, fair and friendly.
• I will have respect for myself and others, as well as respect for authority.
• I will be helpful, caring and considerate to others. I understand that I am responsible for what I say and do.
• I will refrain from bullying any person.
• I understand that I am subject to disciplinary action if I am found guilty of unsportsmanlike conduct, including but not limited
to: verbal, physical, written or cyber abuse; threat or actual destruction of property; slander; illegal drug, underage drinking or
tobacco use. I am responsible for my actions.
I, _______________________________________, understand and agree to follow and promote the AjPHA Code
of Conduct. I understand that I am subject to disciplinary action if I am found to have violated APHA’s rules regarding
unsportsmanlike conduct. I understand that I am subject to disciplinary action if I am found to have participated in verbal,
physical, written or cyber abuse or bullying; threatening to destroy or actual destruction of property; libel or slander; illegal
drug use, underage drinking or tobacco use. I understand that I am subject to disciplinary action if I am found to have broken
the law. I understand that I may be subject to disciplinary action if I choose to conduct myself in a manner that is inconsistent
with the rules, objectives and ideals of the American Paint Horse Association.
Participant Agreement
As a participant in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/AjPHA and
the AjPHA Youth World Games. I understand I will be governed and supervised by my Coach/Chaperone, APHA Director of
Youth Activities and any other APHA staff during my participation at the AjPHA Youth World Games. I have been a member in
good standing of the AjPHA and I am a citizen of the country I am representing.
_____________________________________________ _____________________Signature of Exhibitor Date
_____________________________________________ _____________________Signature of Parent or Legal Guardian Date
SECTION 2: TEAM MEMBERS’ INFORMATION + AGREEMENT (CONTINUED)
Team Alternate*Please include a headshot photograph for each team member.
Name: _______________________________________ APHA ID #: ___________________________________________
Phone Number: ________________________________ Birthday : _______/ _______/ ________ Age: _____________
Address: ______________________________________ Email: _______________________________________________
City: _________________________________________ Country: _____________________________________________
State: __________ Zip: _______________________
AjPHA Code of Conduct
• As an AjPHA member, I will be honest, fair and friendly.
• I will have respect for myself and others, as well as respect for authority.
• I will be helpful, caring and considerate to others. I understand that I am responsible for what I say and do.
• I will refrain from bullying any person.
• I understand that I am subject to disciplinary action if I am found guilty of unsportsmanlike conduct, including but not limited
to: verbal, physical, written or cyber abuse; threat or actual destruction of property; slander; illegal drug, underage drinking or
tobacco use. I am responsible for my actions.
I, _______________________________________, understand and agree to follow and promote the AjPHA Code
of Conduct. I understand that I am subject to disciplinary action if I am found to have violated APHA’s rules regarding
unsportsmanlike conduct. I understand that I am subject to disciplinary action if I am found to have participated in verbal,
physical, written or cyber abuse or bullying; threatening to destroy or actual destruction of property; libel or slander; illegal
drug use, underage drinking or tobacco use. I understand that I am subject to disciplinary action if I am found to have broken
the law. I understand that I may be subject to disciplinary action if I choose to conduct myself in a manner that is inconsistent
with the rules, objectives and ideals of the American Paint Horse Association.
Participant Agreement
As a participant in the AjPHA Youth World Games, I understand and agree to abide by any and all rules of the APHA/AjPHA and
the AjPHA Youth World Games. I understand I will be governed and supervised by my Coach/Chaperone, APHA Director of
Youth Activities and any other APHA staff during my participation at the AjPHA Youth World Games. I have been a member in
good standing of the AjPHA and I am a citizen of the country I am representing.
_____________________________________________ _____________________Signature of Exhibitor Date
_____________________________________________ _____________________Signature of Parent or Legal Guardian Date
