PLEASE PRINT

Mule’s Name_________________________________________ Reg. No._________________________

_________________________________________ Reg. No._________________________

Sex__________ Birth date_____________________

Sire______________________________________ Dam __________________________________

CalBred (yes or no)___________(If yes) CalBred Reg. No.________________________________
 
 

Please make all checks payable to AMRA 2004 World Championship Futurity.
 
 

Check enclosed is the amount of $_____________________
 
 

( ) I am a member of the AMRA.

( ) Enclosed is my $25 membership fee.

Name of owner(s)_________________________________________

Address_________________________________________________
Telephone_____________________
 
 

I hereby agree to abide by the conditions and comply with the Rules and Regulations of the AMRA World Championship 2004 Futurity and further agree to indemnify, save and hold harmless the American Mule Racing Association from any liability that may arise from this entry.

Signature______________________________________

Owner_________________________________________