Rider Name *

First Name

Last Name

Combined Training (CT) Classes *

(Select those you wish to enter)

Puddle Jumpers (Ground Poles/Intro A)

Pre-Amoeba (12"/Intro A)

Amoeba (18"/Intro A)

Fledgling (2'/USEA Starter)

Starter (2'3"/USEA Starter)

Beginner Novice (2'7"/USEA BN A)

Novice (2'11"/USEA Nov A)

Training (3'3"/Tng A)

Prelim (3'7"/Prelim A)

I understand that by submitting this form, I am authorizing Go With It Farm to charge my account in Pike for the full amount of my entry (see fees below). I may cancel my entry without penalty by Tuesday, September 2nd at midnight. If I enter any time after September 2nd, I will be charged in full for my entry.

I absolutely understand! Thanks for putting this together!