| Competition Date |
|
| Riders Name | |
| Membership Number | |
| Email Address | |
|
|
| Horse 1 | |
| Horse's Name | |
| Event1 |
|
| Event2 |
|
| Event3 |
|
| Pony Dressage | |
|
|
| Horse 2 | Please Tick if riding a 2nd Horse |
| Horse's Name | |
| Event1 |
|
| Event2 |
|
| Event3 |
|
| Pony Dressage | |
|
|
GoldClub (Automated)
| RidersJob |
|
| Direct Deposit Only for Online Nominations | |
| Receipt Number | |
SubmissionDate (currentdate&time)
