Office Use Only: Entry Number:__________________ Coggins verified: ________________
	HOWARD COUNTY FAIR 4-H HORSE AND PONY ENTRY INTERMEDIATE - Ages 11 to 13 DUE: JULY 1 with A Current Copy of Coggins
				Name: ____________________________________________________________________________ Address: __________________________________________________________________________ Home Telephone Number: _______________________    Cell Number: _____________________ Age (as of January 1): ___________________   4-H Club: _______________________________ Parents Names: ____________________________________________________________________ Entry Number (located on your Fair pass):  _________________  Horse/Pony Name: ________________________________________________________________                    Coggins Number__________________
		Choose up to 6 English Performance Classes and 3 Western or 6 Western and 3 English from the classes listed below (see class descriptions in the Fair book)
			____15. Intermediate Equitation Walk/Trot/Canter ____16. Intermediate Equitation Over Fences (2'3") ____28. Intermediate Pleasure Under Saddle ____29. Intermediate Pleasure Over Fences (2'3") ____30. Intermediate Pleasure Command ____38. Junior/Intermediate Hunter Under Saddle ____39. Junior/Intermediate Hunter Combo (2'3") ____40. Junior/Intermediate Hunter Over Fences (8 fences not to exceed 2'3") ____62. Western Horsemanship Walk/Jog ____63. Western Horsemanship Walk/Jog/Lope ____64. Western Stock Seat Equitation ____67. Western Pleasure Walk/Jog ____68. Western Pleasure Walk/Jog/Lope ____69. Western Command The following classes may also be entered in addition to your above selection. Showmanship: Choose one ____5. Showmanship - First year of showing in Showmanship ____7. Intermediate Showmanship (11 - 13) Trail: Choose one ____60. Intermediate Trail (11 - 13) Pairs: Choose one ____72/73. Pairs Walk/Trot ____74/75. Pairs Walk/Trot/Canter INSPECTION is mandatory for ALL exhibitors. Inspection points will be used as the final tie breaker in all divisions for Grand Champion. Choose one ____1. First Year Inspection ____3. Intermediate Inspection (11-13) PARENT SIGNATURE (if rider under 18): _________________________   DATE: __________ RIDER SIGNATURE (if rider 18 or older): _________________________   DATE: __________