Entry Confirmation - Please review the following information

Horse Information
Name:	Tesla	Height:	16	Birth Country:
Breed:		Sire:		Year of Birth:
Sex:	Mare	Dam:		Breeder:
Color:	Bay	Dams Sire:		Passport #:

Information	Horse	Rider	Owner	Trainer	Coach
Name:		Robin McKeon		Robin McKeon
Address:		131 Lakeview Avenue		131 Lakeview Avenue
City/St/Zip:		Haverhill, MA 01830		Haverhill, MA 01830
Country:		USA		USA
Telephone:		978-273-8097		978-273-8097
E-mail:		robinmckeon@comcast.net		robinmckeon@comcast.net
Citizenship:		USA
Rider Status:		Adult Amateur
		547311		547311
		211395		211395
Need Safe Sport:		No		No
Need Signature:		No	No	No	No
Need Coggins:	Yes
Need Vaccines:	No
Need Parent Signature:				No
StallGroup:

Need List

Class	Day	Class Name	Test Name	Qual/Div	Need FS Doc	Amount
8	Sunday	USDF Intro Level, Test B	USDF Introductory Level, Test B 2023	No	No	$ 30.00

Stable Fees	Rate	Quantity	Amount

Other Fees	Rate	Quantity	Amount
NHDEA Membership	$ 43.00	1	$ 43.00
Processing Fee	$ 20.00	1	$ 20.00

Payments	Amount
Check	$ 93.00

Class Total	Stable Fees	Other Fees	Total Fees	Payments	Amount Due
$ 30.00	$ 0.00	$ 63.00	$ 93.00	$ 93.00	$ 0.00

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

User	Date / Time	Notes
Secretary	5/31/2023 5:59:50 AM	UPLOADED: PAID VIA CHECK 5/1

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