TEAM Registration for 2021 Pick Your Ride (PYR) Rally
Please fill out one form per team (or partial team) per division.
Individual Competitors need only fill out the INDIVIDUAL form (organizer will place you on a team)
Questions about this event or form? Please contact Shelley Nevins -
, call or text 262-370-8196
Team's Club/Center Affiliation
Please check all clubs for this team if a scramble team
Hillside Farm Riding Center
Kuenzi Equestrian Riding Center
Misty Morning Farm Riding Center
Run O' the Mill
Name of person filling out this form?
Phone # of person filling out this form?
Email of Person filling out this form
Affiliation to Team:
How are you affiliated to the team?
District Commissioner (DC)
Other Club Officer
Team Coach Name:
Each team must have a coach for jumping phases.
Team Coach Phone number:
At what number can your coach be reached while at rally
Is this a full team?
If you only have 1 rider, please do not submit this form, only fill out the INDIVIDUAL form and you will be placed on a scramble team. Teams with 3 or 4 riders MUST find their own stable manager.
yes--5 members (4 riders, 1 Stable Manager) - plus C Advisor - D division only
yes - 5 members (4 riders, 1 Stable Manager) - No C Advisor
yes--3 riders + stable manager, we would prefer to not scramble
no--2-3 riders + stable manager, we need a third and/or fourth rider
no--2-3 riders, we need a stable manager and another one or two riders
As preferred by District Commissioner or Center Administrator. Organizer has the right to assign captains on scramble teams
Team Stable Manager
Teams with 3 or 4 riders are required to send a stable manager, but does not need to be from your club. If you are on a short team and need a stable manager, please put "in need"
Team Other Riders
Please list the other riders on the team, not including the captain
Please include name and a contact number
Special Needs or Notes?
Your team will not be considered signed up for rally until the following forms are received by the Rally Secretary on or postmarked by the closing date (See Guidebook). Please check the last box to indicate you read the list. Mail all of the required paperwork to Shelley Nevins, 1904 Tallgrass Circle, Waukesha, WI 53188.
Completed Online INDIVIDUAL entries for each team member
Email Coggins for each mount (original must travel with mount)
Email Proof of vaccinations as listed in Guidebook
Email non-member waiver (if applicable)
Online Big Valley Waiver
Online Coach form(s)
Online Chaperone Form(s) or Emergency Contact Froms
Online LSR Code of Conduct Form (1 time per year)
Club or Center check payable to Lake Shore Region Pony Club
Club / Center Payment Worksheet for Rally
I have read and understand this checklist.
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