MFTHBA

Regional Versatility Circuit Championship

Participant Application

Name:__________________________________________________________

Address:_________________________________________________________

State, City, Zip:____________________________________________________

Date of Birth:____________

MFTHBA Membership Number:____________________ Copy enclosed: __________

Name of Horse:___________________________________________________

MFTHBA Registration Number:____________________ Copy enclosed:_________

Versatility Circuit Competition Category:

____ Open

____ Amateur

____ Youth

I certify that I have read and understand the MFTHBA Versatility Circuit Rules and Regulations as they apply to the 2007 Show Season and that I will comply with these and the MFTHBA Rules, Standards and Policies/

Signed:_________________________________________

Date:__________________________________________

Show Registration Secretary:(name:)______________________________

__________________________________

***Original and 1 NCR Copy – Original to be filed with the Regional Circuit Management copy to be provided to Applicant as a receipt.