HORSE'S NAME : _____________________________________________________

(MUST USE EXACT NAME ON EACH ENTRY THROUGHOUT THE YEAR )

 OWNER'S NAME : ______________________________________________________________

ADDRESS : ___________________________________________________________________

CITY : ________________________________    STATE :__________    ZIP : _____________

 CRSHA MEMBER   (Y)______    (N) _______    CURRENT COGGINS _________

CLASS #

CLASS NAME

SHOWN BY :

EXH #

FEE

OFFICE USE :

$________________

NOTE: Membership must be carried in the name of the owner of the horse as well as the exhibitor, If not the same household, for points to count towards year-end awards. Points do not accumulate until membership is paid.

WARNING: Under Missouri law, an equine professional is not liable for an injury to or the death of a participant in equine activities  resulting from the inherent risks of equine activities pursuant to the Revised Statutes of Missouri.