South Coast Classics Live 2009
ENTRY FORM
(To be sent with check or money order)
NAME: _______________________________________ REGION 10 # ____
ADDRESS: _____________________________________________________________
_____________________________________________________________
PHONE NUMBER: (__________) _______ - ______________________
E-MAIL ADDRESS:________________________________@___________________
I am entering in OF_______ AR/CM______ Both________
Entry fee: $15. Proxy fee $1 per horse (up to 5).
Lunch: $5 per person
Entry fee_______
Lunch fee_______
Proxy fee_______ name of shower you are proxying for________________________________
TOTAL _______
How would you like results (circle one): email or snail mail (Please include SASE)
Would you like confirmation of this receipt?_______
Please include SASE for mail confirmation.
Please send entry form and check/MO to:
Corrie McDermott
39 Newton St.
Westport, MA 02790