Oregon Region Qualifying Event Rally August 16 -18, 2019 Halsey, Oregon 97348
Please use this form to enter your team of 3 or 4 riders plus Stable Manager. If you do not have a full team, use this form to enter your catch rider(s) and mark this on the entry. We will endeavor to make up teams with catch riders. DEADLINE TO REGISTER: July 21, 2019 NOTE - Training Level will be MODIFIED and not a qualifier for Championships. The cost per competitor is $175 and includes all food for competitors. We will be offering a meal plan for parents/volunteers nearer the event.
Name of Club/Team: *
Your answer
Name of Person Completing this Entry: *
Your answer
Email of Person Completing this Entry: *
Your answer
Phone Number of Person Completing this Entry: *
Your answer
Rider 1 Information:
Name: *
Your answer
Age as of January 1st: *
Your answer
Horse Name (as should appear in program) *
Your answer
Contact Email *
Your answer
Contact Phone number *
Your answer
Team Captain: *
Riding Certification (as of August 1) *
Your answer
HM Certification (as of August 1) *
Your answer
Qualifying for Champs? *
Division Entering? *
Required
If Catch Rider, Name of Club
Your answer
Rider 2 Information:
Name
Your answer
Age as of January 1st:
Your answer
Horse Name (as should appear in program)
Your answer
Contact Email
Your answer
Contact Phone number
Your answer
Team Captain:
Riding Certification (as of August 1)
Your answer
HM Certification (as of August 1)
Your answer
Qualifying for Champs?
Division Entering?
If Catch Rider, Name of Club
Your answer
Rider 3 Information:
Name
Your answer
Age as of January 1st:
Your answer
Horse Name (as should appear in program)
Your answer
Contact Email
Your answer
Contact Phone number
Your answer
Team Captain:
Riding Certification (as of August 1)
Your answer
HM Certification (as of August 1)
Your answer
Qualifying for Champs?
Division Entering?
Rider 4 Information:
Name
Your answer
Age as of January 1st:
Your answer
Horse Name (as should appear in program)
Your answer
Contact Email
Your answer
Contact Phone number
Your answer
Team Captain:
Riding Certification (as of August 1)
Your answer
HM Certification (as of August 1)
Your answer
Qualifying for Champs?
Division Entering?
Stable Manager Information
Name
Your answer
Team Captain?
HM Certification (as of August 1)
Your answer
Qualifying for Champs?
Contact Email
Your answer
Contact Phone
Your answer
Junior/Mini Stable Manager (1 per team) Please make sure parents have read the junior stable manager application, found on ORUSPC website. Parents will sign a hard copy of this application when they check into the rally
Your answer
Junior/Mini Stable Manager parent name
Your answer
Chaperone
Each team is required to have a chaperone. The chaperone can NOT be a coach. The chaperone must be onsite at all times that the team is onsite. In the case of a catch team, you may have multiple chaperones by club but this is not required. One chaperone per team is adequate.
Name *
Your answer
Contact Email *
Your answer
Contact Phone *
Your answer
Volunteer Information
Each team is required to provide two volunteers per day - Friday, Saturday and Sunday.
Volunteers can cover more than one day.
Volunteers will be emailed a link to signup online for the specific shift/job they are interested in covering during the day.
Friday Volunteer #1 Name *
Your answer
Email *
Your answer
Friday Volunteer #2 Name *
Your answer
Email *
Your answer
Saturday Volunteer #1 Name *
Your answer
Email *
Your answer
Saturday Volunteer #2 Name *
Your answer
Email *
Your answer
Sunday Volunteer #1 Name *
Your answer
Email *
Your answer
Sunday Volunteer #2 Name *
Your answer
Email *
Your answer
Payment
Please submit $175 per rider. Four riders = $700, Three riders = $525
Payment can be made via PayPal through the region website. If using PayPal please add a note indicating the team name.
The preferred method is to send a check to ORUSPC Treasurer, Sabrina McDermott,22010 NE 227th Ave, Battleground, WA 98604. Please include a note explaining who is covered in the payment. NO REFUNDS after closing date, without a vet or doctors note and at the discretion of the RS/Rally Organizer.
Method of payment *
Please enter total amount being paid for team/catch rider *
Your answer
If you have any questions please leave them here and a rally organizer will contact you promptly
Your answer
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