THIS IS NOT AN ON-LINE SUBMISSION FORM.    PLEASE COMPLETE FORM, THEN PRINT AND MAIL BACK TO: 

CORNHUSKER FUTURITY, 44080 Dr. 796, BROKEN BOW, NE 68822
               

Cornhusker Futurity Amateur Division

$500 Added

August 17-19, 2012

Custer Co. Fairgrounds, Broken Bow, NE

 

Breeders - Yes No

Open - Yes No

(Choose one division if entered in both futurities)

               
   

Amateur Entry Form

  

Horse's Name

Reg. #

Year Foaled

       Sex 

Color

Sire

Dam

Owner Name

Rider Name

 

Address

Address

 

City/St/Zip

City/St/Zip

 

Phone

Phone

 

E-mail

E-mail

 

               

You may make copies of this form as needed:  ONE entry per form.  Please enclose copy (front and back) of horse’s registration papers with nomination fees.  I agree, by entering the above named horse, to abide by the Cornhusker Futurity/Derby  rules and regulations.  Further, I agree to release the Custer Co. Fairgrounds and the Cornhusker Futurity/Derby staff  from any claims of injury or loss.
               
Signature: ___________________________________________ Date: _____________________________________________
               
FUTURITY BREEDERS AND OPEN AMATEUR DIVISION
Amateur must be a Futurity Entrant.  An "Amateur Entry" is one who has never won $501 and over in any and all barrel futurities prior to December 1, 2011.  The Breeders and Open Amateur division will be combined.   You MUST DESIGNATE your Amateur Status on the enclosed entry form. An entry fee of $60 per horse is required.  Entry due June 1 - no additions or changes will be made after August 1, 2012. The total purse is paid out on two go rounds and an average.  A blanket will be awarded to fastest time on the two run average.  Division of the purse will be:
30% 1st go
30% 2nd go 
40% average on two