ENTRY FORM

CLASS 1: ALLCOMERS INTERMEDIAT (ENTRY FEE £90)
(block capitals please)

NAME OF TEAM	....................................................................................................
TEAM CAPTAIN	....................................................................................................
ADDRESS	....................................................................................................
........................................................................................................................................
POSTCODE...............................................
TEL NO: (HOME)........................................   (MOBILE)..........................................
EMAIL	....................................................................................................

TEAM MEMBERS: NAME OF RIDER and NAME OF HORSE
1 ..................................................................................................................................
.....................................................................................................................................
2 ..................................................................................................................................
.....................................................................................................................................
3 ..................................................................................................................................
.....................................................................................................................................
4 ..................................................................................................................................
.....................................................................................................................................

Eligibility for Old Berks Prize, please indicate: YES / NO
An entry fee of £90 per team ( this includes medical cover ) MUST accompany this entry form.
Please make cheques payable to: Old Berks Hunt Cross Country Event
Entries will close on Friday 19th March 2010