Entry Confirmation - Please review the following information

Horse Information
Name:	Concealed in Gold	Height:	15.1	Birth Country:
Breed:	Thoroughbred	Sire:		Year of Birth:	2017
Sex:	Mare	Dam:		Breeder:
Color:	Palomino	Dams Sire:		Passport #:

Information	Horse	Rider	Owner	Trainer	Coach
Name:		Emily Belanger	Kimberley Sterl	Emily Belanger
Address:		35 North River Rd	317 Goose Pond RD	35 North River Rd
City/St/Zip:		Epping, NH 03042	Canaan, NH 03741	Epping, NH 03042
Country:		usa	usa	usa
Telephone:		6037022809	6034933921	6037022809
E-mail:		eafrazzoni@hotmail.com	srfponies@gmail.com	eafrazzoni@hotmail.com
Citizenship:		usa
Rider Status:		Open
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
6	Sunday	Maiden USDF Intro Level, Test A	USDF Introductory Level, Test A 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 5:59:49 AM	UPLOADED:
Entrant	5/31/2023 6:16:20 AM	ACCEPTED:

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Notes