Entry Confirmation - Please review the following information

Horse Information
Name:	Canadream Dynamo Upper-Babe	Height:	15.3	Birth Country:	can
Breed:	Canadian Horse	Sire:	DU COTEAU MERMOZ DYNAMO	Year of Birth:	2008
Sex:	Gelding	Dam:	SHERMOUNT DYLAN LIVIA	Breeder:	Canadream Farm
Color:	BLACK	Dams Sire:		Passport #:

Information	Horse	Rider	Owner	Trainer	Coach
Name:		ALYSSA EVANGELISTA	ALYSSA EVANGELISTA	ALYSSA EVANGELISTA
Address:		203 Mitchell Road	203 Mitchell Road	203 Mitchell Road
City/St/Zip:		Nottingham, NH 03290-5619	Nottingham, NH 03290-5619	Nottingham, NH 03290-5619
Country:		usa	usa	usa
Telephone:		508-283-0201	508-283-0201	508-283-0201
E-mail:		a_dawidczyk@yahoo.com	a_dawidczyk@yahoo.com	a_dawidczyk@yahoo.com
Citizenship:		usa	usa
Rider Status:		Adult Amateur
	5848151	5505159	5505159	5505159
	1158416	242813	242813	242813
Need Safe Sport:		No	No	No
Need Signature:		No	No	No	No
Need Coggins:	No
Need Vaccines:	No
Need Parent Signature:				No
StallGroup:

Need List

Class	Day	Class Name	Test Name	Qual/Div	Need FS Doc	Amount
18	Sunday	USEF First Level, Test 3	USEF First Level, Test 3 2023	No	No	$ 30.00

Stable Fees	Rate	Quantity	Amount

Other Fees	Rate	Quantity	Amount
Processing Fee	$ 20.00	1	$ 20.00

Payments	Amount
Check	$ 50.00

Class Total	Stable Fees	Other Fees	Total Fees	Payments	Amount Due
$ 30.00	$ 0.00	$ 20.00	$ 50.00	$ 50.00	$ 0.00

Memo
Complete entries must include NHDEA waiver and 12-month coggins!

User	Date / Time	Notes
Secretary	5/31/2023 5:59:51 AM	UPLOADED:
Entrant	5/31/2023 8:45:54 AM	ACCEPTED:

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