ENTRY FORM
INTERMEDIATE 3'3" TEAM CHASE

Name of Team:........................................................................................................
Name of Rider Name of Horse
...................................................... ................................................................
...................................................... ................................................................
...................................................... ................................................................
...................................................... ................................................................
Team Colours:........................................................................................................
Name of Team Captain:..........................................................................................
Address:.................................................................................................................
...............................................................................................................................
...............................................................................................................................
Tel: Day......................................... Evening:..................................................
Mobile:.......................................... Email:......................................................

On behalf of my team I accept the Conditions of Entry as in the Schedule
Signed:...................................................
Date:......................................................

Entry Fee: £88 which includes £2 per person towards ambulances
Entries close on Monday 11th October 2004
No entries will be accepted without the correct Entry Fee.
Cheques should be made payable to "Berkeley Team Event".
Entries to: Mary Evans
3 Walton Rise
Westbury on Trym
Bristol BS9 3EW
Tel: 0117 950 3799

PLEASE ENCLOSE S.A.E. WITH YOUR ENTRY FOR
STARTING TIMES.
PLEASE WRITE ANY POINTS OF INTEREST ABOUT YOUR TEAM
OR IT'S MEMBERS OVERLEAF