Holiday Classic XV - NBHA Super Show
State Fairgrounds Equine Center - Jackson, MS
December 13-15, 2012

Entry Form (separate form required for each rider)

This form can be printed and mailed in.
No Refunds - - - POSTMARKED BY November 19, 2012 - - - No Refunds
Holiday Classic XV

Schedule & Fees
    Process Fee - $25 - One Time fee per contestant
    Race1 - $60 - $6000 added - 12noon Thursday
    Race2 - $60 - $6000 added - 10am Friday
    Multi Race - (Race 3 - $60 - $6000 added)
                       (Yth or Teen Race - $35 - $1000 added each)
                       (Senior Race - $30 - $500 added)
                       8am Saturday
    Stall Fee - $65 - For entire show (all horses on grounds
                                  overnite must be stalled)
    Entries postmarked after November 19 are subject to $25
                                       Late Fee per horse/rider


Please use horse's registered name if applicable
Check race and/or stall where applicable

NAME_____________________________________DOB(Yth/Teen)________SS#______________________

ADDRESS______________________________________NBHA#__________________EXP______________

CITY________________________________STATE______________________ZIP______________

DAY PHONE___________________________________NIGHT PHONE_________________________

HORSE_______________________________________________
Race1___Race2___Race3___Senior___Yth___Teen___Stall_____

HORSE_______________________________________________
Race1___Race2___Race3___Senior___Yth___Teen___Stall_____

HORSE_______________________________________________
Race1___Race2___Race3___Senior___Yth___Teen___Stall_____

HORSE_______________________________________________
Race1___Race2___Race3___Senior___Yth___Teen___Stall_____

MAIL ENTRIES TO:    HOLIDAY CLASSIC
587 POPLAR SPRINGS RD, FLORENCE, MS 39073
MAKE CHECKS PAYABLE TO: WEBB FARMS
ENTRY FEES:              RACE 1:  @$60  $_________
                                   RACE 2:  @$60  $_________
                                   RACE 3:  @$60  $_________
                                  SENIOR:  @$30  $_________
                          YOUTH/TEEN:  @$35  $_________
         STALLS:        $65 X ____            $_________
                          PROCESS FEE           $__25.00__
                          TOTAL FEES:  $__________

(Be sure to include $25 Late fee per Horse/Rider
   For entries postmarked after Nov 19)
$30 FEE FOR RETURNED CHECKS

Visa, Mastercard & Discover accepted (5% fee for credit cards)
Name shown on card ____________________________________  ***Required with card***
Card # ________________________________________Exp_______ Day Phone _____________________
Signature ________________________________________________ Night Phone ____________________
Cardholder acknowledges entry to Holiday Classic in the amount of the Total shown hereon plus 5% and agrees
to perform the obligations set forth in the Cardholder's agreement with the Issuer.
For additional information - Billy Webb 601-845-6003 or 601-955-9322
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