ENTRY FORM

CLASS 3: PAIRS (ENTRY FEE £40)
(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 ..................................................................................................................................

.....................................................................................................................................

An entry fee of £40 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