Entry Confirmation - Please review the following information

Horse Information
Name:	Constantina	Height:	16.2	Birth Country:
Breed:	Oldenberg	Sire:		Year of Birth:	2015
Sex:	Mare	Dam:		Breeder:
Color:	Bay	Dams Sire:		Passport #:

Information	Horse	Rider	Owner	Trainer	Coach
Name:		Tammy Verani	Tammy Verani	Tammy Verani
Address:		73 Page Road	73 Page Road	73 Page Road
City/St/Zip:		Londonderry, NH 03053	Londonderry, NH 03053	Londonderry, NH 03053
Country:		USA	USA	USA
Telephone:		6035055752	6035055752	6035055752
E-mail:		tammy.verani@verani.com	tammy.verani@verani.com	tammy.verani@verani.com
Citizenship:
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
5	Sunday	USEA Eventing Test of Choice	USEA Eventing, Beginner Novice Test A 2022	No	No	$ 30.00
10	Sunday	Maiden USEF Training Level, Test 1	USEF Training Level, Test 1 2023	No	No	$ 30.00

Stable Fees	Rate	Quantity	Amount

Other Fees	Rate	Quantity	Amount
Non-Member Fee (per class)	$ 15.00	2	$ 30.00
Processing Fee	$ 20.00	1	$ 20.00

Payments	Amount
Check	$ 110.00

Class Total	Stable Fees	Other Fees	Total Fees	Payments	Amount Due
$ 60.00	$ 0.00	$ 50.00	$ 110.00	$ 110.00	$ 0.00

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

User	Date / Time	Notes
Secretary	6/2/2023 7:24:21 AM	UPLOADED:

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