Flaming Cattle Event

Flaming Cattle Event
Flaming Star Ranch
Winter 17 - 3930 Hamont-Achel
Belgium
27th september 2014
27 septembre 2014
27 september 2014
DEADLINE 22TH OF SEPTEMBER 2014
DEELNEMINGSFORMULIER | FORMULAIRE D’INSCRIPTION | ENTRY FORM
AQHA & All Breed Cattle Event
Alle formulieren moeten teruggestuurd worden naar:
Tous les formulaires d’inscription doivent être retournés à
To be returned to:
PRAB vzw – Torenlaan 5c – 3945 Oostham – Belgium
Mobile:+32-(0)474-88 19 45
Email: [email protected]
Bank account: KBC 733-0103615-49 PRAB vzw
IBAN: BE97 7330 1036 1549 BIC: KREDBEBB
INDIVIDUELE GEGEVENS / INFORMATION INDIVIDUELLE / INDIVIDUAL INFORMATION:
PAARD / CHEVAL / HORSE
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
_____________________________________________
AQHA Reg. Nr.
_____________________________________________
Geboortedatum / Date de naissance / Birth day __________________________________
Eigenaar/Propriétaire / Owner
 Hengst / Etalon / Stallion
Merrie / Jument / Mare
Ruin / Hongre / Gelding
_____________________________________________
Land Eigenaar / Pays d’origine du Propriétaire / Owner country______________________
AQHA: Gelieve een kopie van het AQHA certificaat van uw paard mee te sturen voor verdere informatie omtrent Uw paard.
AQHA: Prière de joindre une copie du certificat AQHA de votre cheval.
AQHA: For further horse data please make sure to enclose a copy of the AQHA horsecertificate.
VOORBRENGER / EXPOSANT / EXHIBITOR
Naam / Nom / Name
_________________________________________________
AQHA ID
__________________
Adres / Adresse / Address ________________________________________________________________________________
Plaats / Lieu / Place
____________________________________ Postcode / Code Postal / Zip __________________
Land / Pays / Country
____________________________________ Tel / Tél / Phone
Email
__________________________________________________
 OPEN
 AMATEUR
 YOUTH
 NOVICE
________________________
 BEGINNER
 WALK & JOG
AMATEUR & YOUTH:
Relatie Eigenaar/Voorbrenger - Relation entre Propriétaire et Exposant - Relationship Owner/Exhibitor
__________________________________
YOUTH: Geboortedatum / Date de naissance / Date of Birth
__________________________________
AQHA: Gelieve kopies van de lidkaart van ruiter en eigenaar bij de inschrijving te voegen.
AQHA: Prière de joindre des copies de la carte de membre du cavalier et proprietaire aux formulaires d’inscription.
AQHA: Please add copies of the membership cards of rider and owner to the subscriptions
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Individuele kosten / Honoraires individuelle / Individual fees
Show starts at 10.00 am (Cutting)
Concours commence à 10h00 (Cutting)
AQHA Cutting
AQHA Cutting
AQHA Teampenning
AQHA Teampenning
Cutting Open
€ 70
Teampenning Open
€ 15
Cutting Amateur
€ 70
Teampenning Youth
€ 15
Cutting Youth
€ 35
ALL BREED Teampenning
Teampenning Open
€ 15
Teampenning Youth
€ 15
ALL BREED Teampenning
Teampenning Beginners
€ 15
Office Charge (Alleen voor Cutting / Seulement pour Cutting / Only for Cutting)
voor/avant/before 22/09/2014 EUR 10,00 = EUR ________
Na/après/after
22/09/2014 EUR 15,00 = EUR ________
AQHA Fee (Fee/horse when starting AQHA)
Fee when starting AQHA
EUR 4,00 =
EUR ________
Stables / Boxes
Stable FRI—SAT (needs to be reserved and paid before 22/09) _____ x EUR 35,00 = EUR _______
Stable SAT (needs to be reserved and paid before 22/09)
_____ x EUR 25,00 = EUR _______
If possible place my horse near by _____________________________
TOTAAL TE BETALEN / TOTAL A PAYER / TOTAL PAYMENT
EUR ___________
Met mijn handtekening verklaar ik dat het paard ziektevrij de showgrond zal betreden, dat ik zal instaan voor alle kosten voor een dierenartsonderzoek in geval dat het paard symptomen bevat van een besmettelijke ziekte. Ik verklaar hier ook bij dat ik akkoord ga met de regels en
wetgevingen zoals zij weergegeven worden in het showreglement.
Avec ma signature je déclare également d’être d’accord avec les règles et les lois comme stipulé dans le Règlement des concours.
With my binding signature, I hereby state that on the show day the horse will be free of infectious disease, that I will bear all costs related to
a veterinary examination in case the horse should show symptoms of a disease. I also declare to accept all rules and regulations as the appear in the show announcement.
Datum/Date/Date
Handtekening/Signature/Signature
______________________
____________________________________________________
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TEAM / EQUIPE / TEAM
Voor de teampenning dient dit formulier ingevuld te worden (eenmaal per team)
Pour le teampenning, rempli ce formulaire (une fois par équipe)
This form needs to be filled in for the teampenning. (One time for each team)
Team naam / nom d’équipe / Team name _________________________________________________________________
Proef / Classe / Class
 AQHA OPEN
 AQHA YOUTH
 ALL BREED OPEN  ALL BREED YOUTH
 ALL BREED BEGINNER
TEAM MEMBER 1
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
TEAM MEMBER 2
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
TEAM MEMBER 3
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
Team naam / nom d’équipe / Team name _________________________________________________________________
Proef / Classe / Class
 AQHA OPEN
 AQHA YOUTH
 ALL BREED OPEN  ALL BREED YOUTH
 ALL BREED BEGINNER
TEAM MEMBER 1
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
TEAM MEMBER 2
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
TEAM MEMBER 3
Ruiter / Cavalier / Rider
___________________________________________________________________________
Paard / Cheval / Horse
___________________________________________________________________________
Ras / Race / Breed
______________________________________
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Flaming Cattle Event
Flaming Star Ranch – Winter 17 – 3930 Hamont-Achel
ZATERDAG 27 SEPTEMBER 2014 – SAMEDI 27 SEPTEMBRE 2014
Cutting starts at 10.00 am
AQHA Cutting Open
AQHA Cutting Amateur
AQHA Cutting Youth
Teampenning starts at 1.00 pm
AQHA Teampenning Open
All breed Teampenning Open
AQHA Teampenning Youth
All breed Teampenning Youth
All breed Teampenning Beginners
–
On Sunday All Round All Breed show! Check www.prab.be for more information
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