Entry Confirmation - Please review the following information

Horse Information
Name:	POETRY IN MOTION	Height:	17.1	Birth Country:
Breed:	AMERICAN WARMBLOOD	Sire:	NEW YORK CAT	Year of Birth:	2009
Sex:	Mare	Dam:	POETIC LICENSE	Breeder:
Color:	CHESTNUT	Dams Sire:		Passport #:

Information	Horse	Rider	Owner	Trainer	Coach
Name:		Olivia Feil	ISABELLA SAFRAN	Crystal Little	AVA KRUSCHWITZ
Address:		127 HANCOCK ST	21 Oakland Ave	62 Meditation Ln.	57 Meditation Lane
City/St/Zip:		HAVERHILL, MA 01832	SAUGUS, MA 01906-3229	Atkinson, NH 03811	ATKINSON, NH 03811
Country:		usa	usa	usa	usa
Telephone:		9786090705	617-840-9544	603-953-4243	603-819-9618
E-mail:		ollierf.2008@gmail.com	Minniemama@ymail.com	derbytalk@yahoo.com	derbytalk@yahoo.com
Citizenship:		usa
Rider Status:		JR/YR
	5839463	5797839	5811499	4887551	5570195
			239833	130908	224249
Need Safe Sport:		No	No	No	No
Need Signature:		Yes	Yes	Yes	Yes
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
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
Non-Member Fee (per class)	$ 15.00	1	$ 15.00
Processing Fee	$ 20.00	1	$ 20.00

Payments	Amount
Paypal	$ 65.00

Class Total	Stable Fees	Other Fees	Total Fees	Payments	Amount Due
$ 30.00	$ 0.00	$ 35.00	$ 65.00	$ 65.00	$ 0.00

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

User	Date / Time	Notes
Secretary	5/31/2023 5:59:47 AM	UPLOADED: Must submit NHDEA liability form

	Please enter a message to post to the entrant. Please enter the notes for the entrant. Limited to 490 character.
Notes