Online registration United Crown Cup

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Friday 28th and Sunday 30th October

United Crown Cup

Name horse*

Studbook*

Gender*

Color*

Class*

Class A, B, 1, 2 ...

Pregnant Mare

Last date of service

Name Sire*

Name sire of sire*

Name dam of sire*

Name dam*

Name sire of dam*

Name dam of dam*

Copy of Registration Certificate*

Copy of passport (pdf,jpg)*

Name of the person who signs the form*

Address *

City and Country *

Phone*

Email address of the person who signs*

Owner*

Owner address*

Street + nr, zipcode + city, country

Handler*

Breeder*

Name breeder + country, e.g. John Doe, BEL

I, the undersigned person, engage that I and my employees and assistants hold entire responsibility for the horse entered and I accept without restriction the statutes, regulations and jurisdiction of ECAHO. Furthermore, concerning the horse entered, I agree to declare any actual and/or apparent conflict of interest of myself and/or my employees and/or assistants with the judges.

There is an actual and/or apparent conflict of interest with a judge

There is no conflict of interest with any judge

If yes, give the judges name(s)

This entry form is not valid without signature and the full contact details of the person who signs it. The person responsible for the horse is the registered owner or the lessee, but the person who signs the entry form, the handler, and other support personnel including but not limited to grooms and veterinarians may be regarded as additional persons responsible if they are present at the event or have made a relevant decision about the horse.

Capacity in which you sign*

If other, please state

INVOICING DETAILS ALL PRICES ARE 21% VAT EXCLUDED

Options

Number of entry fees in hand class /Liberty Class (€ 150 each/excl VAT (21%))

Number of boxes (€ 200 each/excl VAT (21%))

Number of extra utility boxes (€ 200 each/excl VAT (21%))

Number of parking space caravan, truck, camper (€ 100 each/excl VAT (21%))

Invoice details

Name*

Address (street + nr)*

City*

Country*

VAT nr

INVOICE TOTAL
€ 00,00

Please, remit this sum to our banking account before 10/10/2022
Name: ECPAH vzw, Berkensingel 24, 2490 Balen (Belgium)
Bank: BNP Paribas: accountnumber 230-0139487-21
IBAN BE17230013948721 - BIC GEBABEBB
Use the same name as written in the invoice details as a reference

Registration is only valid after confirmation by the organisation.