WORCESTERSHIRE HUNT TEAM CHASE SUNDAY 26TH FEBRUARY 2012

ENTRY FORM

Class 1	Novice Pairs	£40 entry fee
Class 2	Novice Team Chase	£80 entry fee
Class 3	Intermediate Team Chase (speed class)	£100 entry fee
Class 4	Intermediate Team Chase	£90 entry fee

CLASS:____________

NAME OF TEAM/PAIR:______________________________

	NAME OF RIDER	AGE IF UNDER 17	NAME OF HORSE
1
2
3
4
ENTRY FEE PER TEAM/PAIR			£

I confirm that the team/pairs are eligible for the Special Worcestershire Hunt Prize ........................................YES/NO
Name & Address of Team Captain: _________________________________________
_______________________________________________________________________
_______________________________________________________________________
Post Code: ___________________________	Phone No: ____________________
I, The Team Captain (on behalf of the above) agree to abide by the rules.
Signature: ___________________________	Dated: ________________________
PLEASE NOTE: All riders (or designated adult if rider under 17 years) will be required to sign a disclaimer on collection of their numbers.   Third Party Liability Insurance:  It is a requirement that all participants carry Third Party insurance for not less than £5m.  It is strongly recommended that all participants have Personal Accident Insurance.

NOTES FOR THE COMMENTATOR
Your chance to influence what the commentator might say about you whilst you are riding!!

Name of Team/Pair: ______________________________________________________

Class: _________________________________________________________________

Team Colours: __________________________________________________________

Team Members: ________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Comments: _____________________________________________________________

______________________________________________________________________

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Entries will close at 9pm on Tuesday 21^st February 2012.  Late entries may be accepted if space available at an extra charge of £10 per pair/team.

 

Entry forms to be returned with cheque for the correct entry fee to:

Mrs E Shaw at  Abbeylands, Berry Lane, Upton Warren, Bromsgrove,
Worcs B61 9EL.

All cheques to be payable to: Worcestershire Hunt (Team Chase).