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Welcome to Otter Creek Farm

Mid West JR Challenge Entry Form

Please print and mail this from with a copy of your coggins and fees to:

Lena Warner E5847 1170th Ave Wheeler, WI 54772

Thank you and see you soon!!

Please provide the following contact information:

Street Address
First Name Last Name
 Street AddressHorse Name:
Address (cont.)Birth Date
CityState/Province
Zip/Postal CodeCountry
Home Phone E-mail
Please select your Eventing Class!
Jumper Entry: $20/Class or as stated
Class 200 Class 201 Class 202 Class 203 Class 204 Class 205 Class 206 Class 207 Class 208 Class 209 Class 210 $40 Class 250 $35 Class 260 $35		Dressage Entry: $20 per Class or as stated
Class 1 $10 Class 2 $10 Class 3 Class 4 Class 5 Class 6 Class 7 Class 8 Class 9 Class 10 Class 11
Your Notes:
Total Entry Fees:
Stabling

The online submit form feature does not guarantee your entry in this show, you must mail all your information after submitting your entry to us.