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

August 18-20, 2017

Custer County Fairgrounds, Broken Bow, Nebraska

 

Roll Time from Breeders to Open - Yes No

Rolling time to Open requires 2 separate entry fee payments and

entry form for both the Breeders and Open

BREEDERS FUTURITY ENTRY FORM   $12,000 ADDED

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

 

 

Breeders Futurity payment schedule:

  • 1st payment due June 1st: $150.00

  • 2nd payment due July 1st: $100.00

  • 3rd payment due Aug 1st: $100.00

  • TOTAL PAYMENT          : $350.00

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.

    Payoff for Futurity

 

         30% to 1st go

         30% to 2nd go

         40% to average

               

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:_____________________________________________