Race - Entry Form - Pink Buckle

Pink Buckle

Pink Buckle Futurity & 4D
Oct 5-10, 2021 / $2.7 MILLION DOLLARS

FARRIER ONSITE:

Chad Lewis

405-795-3100 – stall 526

TO RESERVE GOLF CARTS:

4-Wheeler Golf Carts

405-682-8444

HOTELS & LOCAL AMENITIES:

Fairfield Marriott Edmond

301 Meline Drive, Edmond, OK 73034 405-341-4818

Hampton Inn Edmond

300 Meline Drive, Edmond, OK 73034 405-844-3037

LaQuinta Suites Edmond

200 Meline Drive, Edmond, OK 73034 405-513-5353

Local Amenities

https://www.lazye.com/restaurants-hotels

The Pink Buckle
6538 So River Dr Spanish Fork, UT 84660

Office
801-923-1517 | office@pinkbuckle.com
www.pinkbuckle.com

2021 Nomination Form

October 5-10, 2021 Lazy E Arena, Guthrie, OK

Entries are due August 20, 2021

All horses have to be nominated every year in order to remain eligible to compete.

Only horses sire by Pink Buckle Stallions are eligible to compete.

Please complete the * required fileds.

* Horses Registered Name

* Year Foaled

* Registration Number

* Sex

* Color

* Sire

* Dam

* Dam Sire

* Rider

* Rider Phone Number / Email Address

Owner

* Name

* Address

* City

* State

* Zip

* Phone Number

* Email Address

Breeder

* Name

* Address

* City

* State

* Zip

* Phone Number

* Email Address

* You may roll your time from Futurity to 4D - you will run in the Futurity. Please check both boxes.
1 exhibition comes with every entry / will run in draw order on Wednesday, October 6, 2021

$300 Nomination Fee (ONLY if NOT already paid in 2021) $500 4D, 1/2 sec splits $500 2D Futurity (4 and 5 years old $500 Derby $250 Amateur Futurity / Must enter Futurity (includes Amateur Status Form) $250 Sale Graduate Futurity Sidepot (only for horses purchased through Pink Buckle Sale in ‘19 or ‘20) $250 Sale Graduate 4D Sidepot (only for horses purchased through Pink Buckle Sale in ‘19 or ‘20) $250 4D Owner / Ride Sidepot 3D Youth Incentive / Must enter open 4D (no extra fee, 16 and under at time of race - must provide poor of age

* You may roll your time from Futurity to 4D - you will run in the Futurity. Please check both boxes.
1 exhibition comes with every entry / will run in draw order on Wednesday, October 6, 2021

I agree that I have read the rules and fully understand them and that The Pink Buckle LLC assumes no liabilty.

Please include copy of completed W-9 with this entry form. Download W-9 here.

* Upload W-9

UPLOAD

Pink Buckle Amateur Futurity Rules

Must not have won over $40K in earnings over the last 5 years.
Must provide current Equi-Stat Report (within 2 weeks of Amateur application) verifying that you have earnings less than $40K over the last 5 years.
Must not hold a current WPRA card.
Must not train barrel horses for compensation.
You or an immediate family member must own the horse you are entering in the Amateur Futurity division and have current AQHA registration papers verifying this info.

Should the Pink Buckle determine an Amateur contestant has made a false declaration, they will forfeit ALL winnings earned during the race and will be disqualified. When a horse / rider to be ineligible, the earnings and awards will be forfieted to the Pink Buckle. It is the contestants responsibility to return all earnings and awards to the office secretary immediately. Pink Buckle reserves the right to make any changes they deem necessary.

I verify that the above info are correct.

I agree with the Pink Buckle's Privacy Policy and Terms and Conditions. Proceed to Payment