2015
MILE HIGH DERBY
OPEN TO THE WORLD
$40,000 Added by Arapahoe Park - Estimated Purse $100,000
TENTATIVE DATES - TRIALS – July 31, 2015 FINALS – August 15, 2015
For 3 year old AQHA foals of 2012 124 lbs
400 yards
THERE WILL BE NO REFUND OF FEES: 5% of all fees will be held for administrative and advertising purposed by the
Rocky Mountain Quarter Horse Assn.
PAYMENT SCHEDULE
LATE NOMINATIONS
Late nominations may be made
March 15, 2015 - to sustain
$300.00
April 15, 2015 - to sustain
$300.00
April 15, 2015 – penalty + original
$ 900.00
May 15, 2015 - to sustain
Then – May – June – July
= $1,800.00
$300.00
OR
June 15, 2015 - to sustain
$300.00
May 15, 2015 - penalty + original
$1 500.00
July 15, 2015 - to sustain
$300.00
Then June & July
= $2,100.00
Total
$1,500.00
SUPPLEMENTAL PAYMENT - LATE ENTRY - PAYMENT AT TIME OF ENTRY July26, 2015 $ 3,500.00 (Includes all payments)
All nominations and sustaining payments should be sent via USPS registered or certified mail or courier service (UPS , FedEx, etc) and
postmarked no later than the due date. The senders receipt must be presented, as proof should any discrepancy occur. There will be no
exceptions to this rule!
No Consolation - General Conditions On Reverse Side.
MAIL ALL NOMINATION BLANKS AND PAYMENTS TO: Rocky Mountain Quarter Horse Assn., 22 S 4th Ave., Suite 101,
Brighton, CO 80601
(303) 659-7752
FAX (303) 659-7754
e-mail: [email protected]
2015 MILE HIGH DERBY
NAME OF HORSE
SEX
AGE
SIRE
DAM
3
3
3
Release of Liability or Wavier of Liability
I, the undersigned, and my Parent/Guardian, if applicable, do hereby release, indemnify, and hold harmless the Rocky Mountain Quarter Horse
Association, its Board of Directors, officers, agents, employees and volunteers or any sponsor as well as other participants and spectators from
any and all liability claims, demands and actions whatsoever arising out of or related to any loss, damage, or injury, including death, which my be
sustained by me or to any property belonging to me. The terms hereof shall also serve as a release and assumption of risk for my heirs, executor
and administrator and for all members of my family, and may be pleaded as a bar to litigation. Jurisdiction of this matter and venue shall lie
exclusively at Arapahoe Park, Arapahoe County, Colorado. By my signature I agree to all Terms and Conditions as written on this form.
________________________________________
Signature of Owner
____________________________________________
Signature of Parent/Guardian
____________
Date
_______________________________________________________________
Print Name of Owner
___________________
Date
________________________________________________
Print Name of Parent/Guardian
OWNER__________________________________________________________TRAINER __________________________________________________________
ADDRESS___________________________________________________________________________________________________________________________
PHONE __________________________________
SIGNED___________________________ ______________________________