2005 Keuring Site Registration Form

Owner Name
 
Street Address City State Zip
       
Phone Fax Email
     

Please include photocopies of your Coggins (current within 6 months from outside Connecticut, current within 1 year for those in Connecticut), Rabies, proof of Influenza vaccine and a current Health Certificate with this form.   Bring the originals with you when you come to the site.

If you wish to reserve a stall and purchase bedding, please indicate below.  Stalls are limited and are a first come, first served basis.  Please return this form as soon as possible in order to guarantee your stall.  If reserving stalls, indicate day stall will be needed.  Please, if you are only showing one day, only fill that stall for that day if possible as stalls are limited.  Due to the limited number of stalls, we will not be offering tack stalls.

Horse Name ($45 site fee per horse) Stalls needed ($30 per stall per day) # Bags of bedding needed ($5 per bag)
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  
  Thurs     Fri     Sat  

Would you like a camping site?  The fee is $25 per night.  (please circle one)   Yes    No

Total fees to be returned with this form:  $_______________

Please make checks payable to FHCNE and mail to:

Margo Farnsworth
359 Spencer Rd.
Oakham, MA  01068