! ! 1! ! BELGIAN!APPALOOSA!CHAMPIONSHIP!2014! 16!&!17!August! Triple!Pointed!Show! Formulaire!d’inscription/!Nomination!Form!(1/3)! ! Horse/!cheval!:!………………………………...………………………..ApHC!number!:…………………….! ! Sexe!:!(!)!mare!(!)!gelding!(!)!stalion!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!année!de!naissance/!birth!date!:!………..! Owner/!propriétaire!:! ! Nom/!surname!:!…………………………………………..…..!!!Prénom/!first!name!:…………………………………….! ! ApHCUBelgium!:…………………!!!!!!!!!!!!!!!!!!!!!ApHCUUSA!:…………………………! ! Adresse/Adress!:!……………………………………………………………………………………………………………………..! Code!postal/!postcode!:……………..!!!!!!!!!!!!!!!!Ville/Town!:……………….!Pays/!country!:! ! Téléphone!:!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!eUmail!:! Rider/!cavalier:! ! Nom/!surname!:!……………………………..!!!Prénom/!first!name!:…………………………………….! ! ApHCUBelgium!:…………………!!!!!!!!!!!!!!!!!!!!!ApHCUUSA!:…………………………! ApHC!non!pro!card!!O! Relation!propriétaireUcavalier!pour!nonUpro!et!youth/! Relation!owner/exhibitor!for!nonUpro!&! youth!:…………………………………………………………………………………………………………………….! ! Adresse/Adress!:!…………………………………………………………………………………………………….! Code!postal/!postcode!:……………..!!!!!!!!!!!!!!!!Ville/Town!:……………….!Pays/!country!:! Téléphone!:!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!eUmail!:! Couts/!costs!:!Membre!BA!&!European!Club!!!!Couts/costs!:!NonUEuropean!Club!member! ! Open!!!!!!!!!!!30€!x…...=…….!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Open!!!!!!!!!70€!x…..=…….! NonUPro!!!!!25€!x…….=!…….!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!NonUPro!!!50€!x…...=…….! Youth!!!!!!!!!!20€!x….....=…….!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Youth!!!!!!!!50€!x…...=…….! ! ! Forfait!donnant!accès!à!des!classes!aux!choix!/!fee!classes!package!:! 4!épreuves!et!moins/!4!classes!&!less!:!!!!!!!!!5!épreuves!et!plus! forfait!classes!open!:!!!!!!!€!90!!!!!!!!!!(!)!!!!!!!!!!!!!!!!!!!€!110!!!!!!!!!(!)! forfait!classes!nonUpro!:!€!70!!!!!!!!!!(!)!!!!!!!!!!!!!!!!!!!€!90!!!!!!!!!!!!(!)! forfait!classes!youth!:!!!!!€!50!!!!!!!!!!!(!)!!!!!!!!!!!!!!!!!!!€!70!!!!!!!!!!!(!)! ! forfait!ouvert!aux!membres!d’un!club!européen!uniquement/!only!for!members!of!EU!Appaloosa! associations! ! ! Office!Charge!:!! Belgian!Appaloosa!member!!!!!!!!!!!!€!15!!!(!)! NonUBelgian!Appaloosa!member!!!€!25!!!(!)! ! TOTAL!:!………………!€!!!!paid!to!the!«!Belgian!Appaloosa!»! ! ! ! ! Open!Classes! ! class code O 021 O 022 O 023 O 030 O 031 O 032 O 033 O 034 O 053 O 054 O 055 O 056 O 058 O 073 O 074 O 075 O 076 O 077 O 086 O 090 O 092 O 341 O 342 O 343 O 360 O 381 O 382 O 400 O 421 O 422 O 427 O 428 O 441 O 442 O057 ! ! ! ! ! ! ! BELGIAN!APPALOOSA!CHAMPIONSHIP!2014! 16!&!17!August! Triple!Pointed!Show! Formulaire!d’inscription/!Nomination!Form!(2/3)! description Hunter in hand Stalions Open Hunter in hand Mare Open Hunter in hand Geldings Open Weanling Colts Open Halter Yearling Colts Open Halter Two-Year old Stalions Open Halter Tree-year old Stalions Open Halter aged Stalions Open Weanling Fillies Open Halter yearling fillies Open Halter Two-Year old Mares Open Halter Tree-Year old Mares Open Broodmares Weanling geldings Open Halter yearling geldings Open Halter Two-Year old geldings Open Halter Tree-Year old Geldings Open Halter Aged gelgings Open Most colorfull Open Get of Sire Produce of a dam Reining junior (Open) Reining senior Open Reining Hackamore/Snaffle bit Western riding all ages (Open) Trail Junior Open Trail Senior Open Hunter hack all ages (Open) Western pleasure Junior Western pleasure Senior Western pleasure tree year old snaffle-bit Yearling longe-line Open Hunter under saddle Junior Hunter under saddle Senior halter Aged Mare Open X ! ! 3! ! ! NonU!pro!classes! class code N 120 N 310 N 320 N 330 N 340 N 350 N 370 N 500 N 510 N 520 N 530 N 540 BELGIAN!APPALOOSA!CHAMPIONSHIP!2014! 16!&!17!August! Triple!Pointed!Show! Formulaire!d’inscription/!Application!from!(3/3)! description Hunter under saddle 19 & over (N-P) Western Showmanship 19 and over (N-P) Western Horsemanship 19 & over Western pleasure 19 & over (N-P) Western riding 19 & over (N-P) Trail 19 & Over (N-P) Reining 19 & over (N-Pro) Halter all ages Stalions N-Pro Halter Mares all ages Non-pro Halter all aged Geldings N-pro Yearling longe-line N-P Most colorfull at halter N-P x Novice!Amateur!classes! class code N319 N159 description Western Showmanship novice non-pro Hunter hack Novice Non-Pro x Youth!classes! class code Y 110 Y 140 Y 190 Y 270 Y 290 Y 320 Y 340 Y 380 description Showmanship at Halter 18 and under (Youth) Western Horsemanship 18 & under Reining 18 & under (Youth) Western riding 18 & under (Youth) Trail 18 & under (Youth) Hunter under saddle 18 & under (Youth) Western pleasure 18 & under (Youth) Hunter hack 18 & under (Youth) x ! ! ! I!hereby!accept!to!follow!the!rule!of!the!Belgian!appaloosa!Show!Policy!and!the!rule! of!the!ApHC! !!!!!!!!!!!!!J’accepte!de!suivre!les!règles!du!Belgian!!appaloosa!show!Policy!et!les!règles!de!l’ApHC.! ! ! Date!:! ! ! ! ! ! ! signature!:! ! ! Information!for!paiement!:!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Need!any!other!information!?! Asbl BELGIAN APPALOOSA vzw please contact Stijn de Frene Chemin d’Impegnies 62 7810 ATH GSM (NL-FR-EN): +32 495 53 06 19 IBAN!BE22!2700!1954!4947!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!stijn@belgianappaloosa.be! BIC!GEBABEBBc! BELGIAN!APPALOOSA!CHAMPIONSHIP!2014! 16!&!17!August! Triple!Pointed!Show! ! ! Stall!booking! Hérock!,!August!2014! ! Prix /price 15 € 30 € 45 € + 25 € Stall fee for 1 day Stall fee for 2 days Stall fee for 3 days Copeaux/ shaving # Horses x x x x = = = = € € € € Copeaux disponible sur place à 15 €/ shaving available on site for 15 € Name!!!!!!!!!!!!!!!!!!!!! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! sex! ! Straw/shaving! ! Date!of!arrival! ! Date!of!departure! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Contact!:!! Stijn!De!Frene! [email protected] GSM (NL-FR-EN): +32 495 53 06 19 !
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