Pennsylvania Horse Show Association (PHSA)
2017 Horse Show Application

Important Information

·  Points will not count until horse show payment is received in full.

·  Show results must be received within 10 days of the show ending.

·  Please include rider USEF #, Owner USEF #, and Horse Recording/ID for the first through 8th place winners and the number of exhibitors in the division.

·  Horse Shows must adhere to PHSA specs when offering PHSA recognized divions in order for points to count.

Horse Show Information (Please print clearly) - Complete 1 form per show

Show Name______Date(s):______USEF Rating______

Location (City, State)______USEF Show ID#______

Show Manager:

Name______USEF#______

Phone ______

Address______

Email______

Select PHSA Recognized Divisions To Be Offered:

Performance / Breeding
q  All Performance Divisions listed below / q  All Breeding Divisions listed below
q  Green Pony
q  Small Pony
q  Medium Pony
q  Large Pony
q  Small Junior
q  Large Junior
q  Amateur Owner 3’3”
q  Amateur Owner 3’6”
q  Baby Green/Young Hunter
q  Pre-Green Hunter
q  Green Hunter
q  Performance Working Htr
q  Low Hunter
q  Adult Jumper
q  Children’s Jumper
q  Pony Jumper
q  3’3” Junior Hunter / q  Modified Hunter
q  Short Stirrup Hunter
q  Short Stirrup Equitation
q  Pre-Children’s Sm/M Pony
q  Pre-Children’s Large Pony
q  Pre-Children’s Horse 14 & Under
q  Pre-Children’s Horse 15-17
q  Children’s Sm/M Pony
q  Children’s Large Pony
q  Children’s Horse 14 & Under
q  Children’s Horse 15-17
q  Preliminary Adult
q  Adult Amateur 18-35
q  Adult Amateur 36 & Over / q  Amateur Handler
q  PA Bred Yearling Colt/Gldg
q  TB and Non-Registered TB Yearling Colt/Gldg
q  Non-TB Yearling Colt/Gldg
q  PA Bred Yearling Filly
q  TB and Non-Registered TB Yearling Filly
q  Non-TB Yearling Filly
q  PA Bred 2 yr old Colt/Gldg
q  TB and Non-Registered TB 2 yr old Colt/Gldg
q  Non-TB 2 yr old Colt/Gldg
q  PA Bred 2 yr old Filly
q  TB and Non-Registered TB 2 yr old Filly
q  Non-TB 2 yr old Filly / q  PA Bred 3 yr old
q  TB and Non-Registered TB 3 yr old
q  Non-TB 3 yr old
q  Mares 4 yr old and older
q  PA Bred Yearling Pony
q  Yearling Pony Colt/Gldg
q  Yearling Pony Filly
q  PA Bred 2 yr old Pony
q  2 yr old Pony Colt/Gldg
q  2 yr old Pony Filly
q  PA Bred 3 yr old Pony
q  3 yr old Pony
q  Young Pony Under Saddle
q  Young Working Hunter Under Saddle
q  Young Hunter Under Saddle

Payment Information (Please print clearly)

q  A or AA with or without breeding: $100

q  B or C with or without breeding: $50

q  USEF Horse Show offering breeding classes only: $25

Credit Card Type______Name on Card:______Expiration Date:______

Billing Address (City, State, Zip)______

Credit Card Number:______3-Digit Security Code______

Mail payment along with form in order for points to count to: Mail results for Performance and Breeding to:

PHSA PHSA

c/o Doris MacDonald c/o Locke Ellen Kelly

1892 Little Road, Perkiomenville, PA 18074 600 Green Hill Road, West Chester, PA 19380

Payment Method: __Check OR __Credit Card email: