Coastal Dressage Extravaganza Entry Form

COASTAL EQUESTRIAN CLUB ONLINE DRESSAGE EXTRAVAGANZA

SPONSORED BY TRAILRACE SADDLERY
RIDER DETAILS
Rider Name

First Name Last Name

Address (please ensure it is correct for mailing purposes)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Mobile or phone number
Email
example@example.com
Judging Conflict
Type judges name you have a conflict with - must be according to HRCAV/EA rules
MEMBERSHIP DETAILS

You must be a EA or HRCAV member or pay the event insurance fee
EA member number
HRCAV member number
Are you riding a pony?

YES
HORSE DETAILS
Horse's Name