The Pam Bell Challenge – Entry Form

All Entry Fees are G.S.T. Inclusive

Subject to the Rules, By-Laws and Regulations of the Society and the Queensland Chamber of Agricultural Societies, which are deemed included herein as if inserted at length. I submit the following entries at the forthcoming show, the Exhibits being my own bona fide property, herewith.

Download and print the form or complete the form below.

Name of Rider/s Name of Horse/s Entry Fee
Name and Address must be given for all entries
Entry fee must accompany Entry.
Name*
First Last
Address*
Street Address City State Postcode Country
Telephone*
Email*
Bank Account Details:
BSB*
Account Number*
In case Refunds need to be paid or to pay Prize Money
I am registered for G.S.T.*
- Yes
- No
My A.B.N. is
The Supply is made to me in my capacity as an individual, and is made in the course of an activity that is a private recrea- tional pursuit or hobby.*
- Yes
- No

Signed Event Waiver and Horse Health Declaration must be supplied on the day.

Name of Rider/s	Name of Horse/s	Entry Fee