Regional Entry Form - For RS Use Only!

COMPLETE ENTRIES MUST INCLUDE THE FOLLOWING:

1. Entry for the team (teams are NOT mixed levels unless indicated), or individuals.
2. Regional Check for the entry fee & applicable penalties made Payable to USPC
Midwest Region.
3. 1 copy of Current Negative Coggins Test, dated within 12 months of Aug.10, 2010.
Name of horse on Coggins to match name on entry.
4. Signed Activity and Rally Release for each competitor
5. Signed Chaperone Duties Form per team/ individual
6. Signed Coaches' Guidelines Form (where appropriate)
7. Volunteer Form (see Mandatory Volunteer Requirements) – each Team/Individual Entry
8. Games entry must also include the TD report and a copy of the Program from
Qualifying Rally signed by the TD.
9. Show Jumping entries must include a copy of the Steward’s report and the qualifying
rally score sheets showing the qualifiers, three complete rounds.
10. Eventing Qualifying Affidavit, where appropriate
11. All Eventing competitors must also complete both sides of the USEA event entry
form, with all required membership, horse registration numbers and signatures. Parents
are to sign as trainer if trainer will not be present at competition.

Competitor Packets will be available beginning Tuesday, August 3rd. No packet will be
released to a competitor with outstanding fees or missing paperwork.

All forms are available on the USPC website under publications/forms.

All forms must be filled out completely!

Entries should be mailed to the Secretary along with the paperwork and postmarked
by closing date.
USPC Champs Midwest RS Information
Copyright United States Pony
Clubs, Inc.  All rights reserved.
USPC Championships Midwest 2010
Bottom two photos on this page courtesy of Merrick Studios; all site photos of
American Royal courtesy of Kathy Wismer Photography.