| Summerhouse Affiliated Showjumping - ENTRY FORM | ||||||||||
| Summerhouse Education & Equitation Centre | ||||||||||
| Hardwicke, Gloucester, GL2 2RG | ||||||||||
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Date of Show: …………………………………………………………………….. |
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| Please note: Payment by Cash or Card only : all entries must be paid by end of day, otherwise a £20 fee will be incurred. | ||||||||||
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Class |
please state Fox/New/Open |
Horse or Pony Name |
BSJA Reg. No. |
Rider's Name |
BSJA Membership No. |
Entry Fee |
| £ | ||||||
| £ | ||||||
| £ | ||||||
| £ | ||||||
| £ | ||||||
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| Paramedic First Aid Charge £2 per horse, maximum £4 per competitor | £ | |||||
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TOTAL: |
£ |
Please can all entry fees be paid when entering or leave card details with first entry - THANK YOU
CARD DETAILS: (Amex cards not accepted)
HOUSE/FLAT NUMBER :
POSTAL CODE :
CARD NUMBER:
DATE OF EXPIRY:
3 DIGIT CODE:
NAME ON CARD:
ISSUE NUMBER:
Name....................................................................................... (Do you have Summerhouse Membership? If Yes state membership number )
Address................................................................................................................................................................................................................................
Postcode........................................................................
Tel Number....................................................................
Email..............................................................................
Please insert and we can send updated schedules
Please return form to:BSJA Entries, Summerhouse Equestrian Centre, Bath
Road, Hardwicke, Glos, GL2 2RG
Fax number 01452 7623688 email gallop@summerhouseec.co.uk