Address:

City: State: Zip:

e-mail:

I'd like my table near: (we'll try to accomodate your requests)

FEES: amount enclosed

OF Youth Division only (unlimited)	$20
OF Plastic Mini Division only (unlimited)	$20
OF Division only (unlimited)	$30
CM/AR Division only (unlimited)	$30
Any combo of above divisions	$50
OR Per Horse Fee: $20 for 1st model; $5 each additional
Proxy $5 per model; $20 unlimited
Sales-Only Table or Extra Table	$15
Entry received May 31 - June 6	$5 extra
Entering on show day	$10 extra

ARE YOU A  4-H MEMBER?  o    Yes     o    No

OPTIONAL BOX LUNCH: ORDERS MUST BE PLACED (AND PAID FOR) BY FRIDAY, MAY 30
         $6.00 each; Includes: sandwich, veggie, fruit, chips, & soda (or similar combination)
         # of lunches _____ x $6 = $_________

For each sandwich, choose from the following:
Name: ______________________________
Choice:     Turkey                       Roast beef               Vegetarian
Choice:     Sourdough              Wheat
Choice:     Swiss        Cheddar        Cream Cheese
Choices:    Mayo        Lettuce        Tomato
Choice:     Coke        Diet Coke        7-Up        Bottled Water

SPONSORSHIPS: (optional) (for each $1 of sponsorship, your name goes in special drawing)
____ classes x $1 each (get free classified or business card ad)
____ championships x $5 each (gets free full page ad)

ADVERTISING IN PROGRAM:

Classified (50 words or business card)	$1.00
Half page (copy ready)	$3.00
Full page (copy ready)	$5.00

checks payable to: Traci Durrell-Khalife TOTAL FEES___________

TO GET EXHIBITOR IDENTIFICATION CODE: (please check one)
o    I've listed an e-mail  address
o I'm enclosing a SASE
   OR
o    I'm participating in the Region 1 "Tag Saver" Program. My entrant code is: __________
        (click here to sign up for the optional "Tag Saver" Program )

MODEL LIST:
You must provide a typed (or neatly printed) list of models you are showing; it must have your name at the top, be numbered 1,2,3, etc. in ascending order (OK to skip numbers), must include each model's name, breed and finish (OF, CM, or OF Plastic Mini); list may be submitted now, later via e-mail, or on show day; any changes or additions must be provided in writing to the showholder (forms and a drop-box will be provided)

Donations: I plan to donate the following item(s):________________________________
for o Auction (items valued over approx. $20; ___% donation [50% min.]; submit your free full page ad --copy ready)
for o Raffle (items valued over $10; submit your free full page ad --copy ready)
for o Door Prize (items valued under $10; submit your free classified ad or business card)
(donors' names go into special drawing)

The undersigned, on behalf of himself or herself, or if signed by a parent or guardian on behalf of the parent's child or guardian's minor, waives and releases Northwest Expo, its agents and representatives, from any claim or cause of action for any incident, injury, loss or damage to participant or the participant's property suffered as a consequence of or arising out of participation in Northwest Expo Model Horse Show.

Signature of Parent/Guardian
or Adult Exhibitor ________________________________________________

#   Model's name

Breed

CM/AR

OF

OF Plastic Mini