PLEASE PRINT

NAME:

ADDRESS:

CITY/STATE/ZIP:

PHONE:

CELL PHONE:______________________________________________

EMAIL:

HORSE(s) NAME:___________________________________________

_________________________________________________________

Circle one:

SINGLE $20 FAMILY $30

FAMILY NAMES: ____________________________

MAKE CHECKS PAYABLE TO: DRAW

MAIL TO: Jill Feller - N9280 Cty Hwy TW- Mayville, Wisconsin 53050