SHAMROCK SHUFFLE NO FRILLS

ENTRY FORM

Send Entries to: Barb Ness, 903 NE 4^th Avenue, Camas, WA 98607

Make check or Money Order payable to: Barb Ness

Non-credit card paypal ID is: barbness@comcast.net

Name: Daytime Phone:

Address: Email:

City: State: Zip:

Region 1 Tag # __________

Entry Fee:

Item	Price	Quantity	Total
Flat show entry fee	$25.00
Class sponsor (please indicate below)	$1.00/class
Section Sponsor (please indicate below)	$5.00/section
Division Sponsor (please indicate below)	$10.00/division
Total Amount Due:

I will sponsor the following: (class) ____________________________

(section) ____ ______________________

(division) __________________________

*By signing this form and attending Shamrock Shuffle No Frills, I hereby release Shamrock Shuffle No Frills, the Camas Community Center and Barb Ness from liability for loss, damage or injury to any person or property which may occur during the show activities.

Signature:_____________________________________________________________________

(Parent or Guardian if entrant is a minor)

Please PRINT or TYPE this form, to avoid misspelled model names. Please keep stable initials or words to a minimum. You may copy this form as many times as needed.

Name: Phone or email:

Tag#

Model Name

Finish (CM, AR, CMG)

Breed