The 5th Annual UK Hunt Team Chase

ENTRY FORM

Name of Team Captain:

Address for correspondence:

Telephone:

Name of Hunt:

Name of Team: Must include name of Hunt in front (eg. Fernie Friendlies)

Name of rider:	Name of horse:
Team Captain

All participants must carry Third Party Liability Insurance for not less than £5 million which is available through membership of the Countryside Alliance. It is also strongly recommended that all participants have Personal Accident Insurance.

MASTER'S CERTIFICATE

I hereby CERTIFY that ALL members of the team named above are SUBSCRIBERS to the ................................................ Hunt and each has hunted with that Hunt on at least 4 occasions during the current season.

Name of Master of Hunt (please print):

Signature of Master:

Date:

ENTRYCHARGE FOR THE UK HUNT TEAM CHASE - £60.00 per Team (cheques made payable to Fernie Team Chase) In addition to the entry charge, there will be a declaration fee of £20 per team payable on the day of the event.

Please return the entry form with CHEQUE for £60.00 (payable to Fernie Team Chase) to arrive no later than 8pm on Monday 21st March 2005 to the Hon. Secretary:-

Katie Harpham, Sundial House, 2 Old Holt Road, Medbourne, Market Harborough, Leices, LE16 8DY.

Penalty for late entries £15 extra per team - which will be strictly enforced on declaration.
Please note that valid entries cannot be made by phone - only post or fax.

Team times will be advertised on www.teamchasing.co.uk prior to the event
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Please provide any details that may be of interest for the commentator on the back of the entry form.