At The Glebe, Etchingham Road, Burwash, East Sussex  TN19 7BG

 

Jockey:                                                         Owner(s):                                    .

Address:                                                         Address:                

           

 

 

 

            Tel No:                                                            Tel No:    

E-mail:

(please complete to enable me to e-mail you next year’s entry form)

 

 

Colours:                                                                                                                    

 

Horse: Name:……………………Colour……….Age……Sex……Breeding:……………

 

 

Entry Fee: £40 per horse, cheque made payable to ESRM Hunt

                                              (Please put name & address on reverse of cheque)



Agreement:

By entering The Scurry of East Sussex, I agree to comply with the rules and accept that I compete entirely at my own risk and that the organisers and the landowners are not responsible for any accidents, loss, damage, injury, whatsoever and that no claims will be made against them or others associated with them by myself or the owners of the horse.

 

Jockey’s signature:                                                 Owner’s signature:

Date:                                                               Date:

 

Commentator Information:

Rider: (Past achievements and points of interest):

 

 

 

 

 

Horse: (Breeder, Sire, Dam, past form):

 

 

 

 

 

Please send entry form & cheque for £40.00 made payable to ESRM to:

Hannah Taylor, Holly Lodge, Mountfield, Sussex TN32 5LP 

Tel: 07867 784171, Fax: 01580 881757,

E-mail: Hannah.courtneybennett@btinternet.com

Entries will close on Wednesday, 10th March, late entries £60 per horse.