FUTURITY NOMINATION FORM

( Place a check mark next to each class entered)
____ Non-Pro Weanling Colts & Geldings
____ Weanling Colts & Geldings
____ Non-Pro Weanling Fillies
____ Weanling Fillies
____ Yearling Colts
____ Yearling Geldings
____ Yearling Fillies
____ Yearling Longe Line
____  Non-Pro Yearling Longe Line
____ 2-Year Old Western Pleasure
____ 2-Year old Hunter Under Saddle
____ Western Pleasure Stakes - 3 Years & Older
____ Hunter Under Saddle Stakes - 3 Years & Older
____ Non-Pro Pleasure (Western & HUS Combined)
____ All Age Trail
____ Lead Line - Open to Riders, 8 Years & Under
____ All Age Walk/Trot - Open to All Ages of Horses & Riders

A copy of the BREEDERS CERTIFICATE or CERTIFICATE OF REGISTRATION must be submitted with each entry & CLUB MEMBERSHIP must be current.

Name of Horse_____________________________________________________________

Owner(s) Name___________________________________ 
Phone #__________________

Owner's Address________________________________________________________

Owner's Soc Sec #___________________ 
Email Address:_________________________

Mail Entry Form & Payment (payable to DPHC Futurity) to:
Debbie White · 54 Derbywood Circle · Dover, DE 19904
(302) 697-1948 ~~ Email: dcauffwhite@yahoo.com