MONROE COUNTY FAIR LIGHT HORSE ENTRY
SENIOR (THURSDAY) SHOW
EXHIBITOR INFORMATION (PLEASE PRINT)
Address: __________________________________
Please Note: A negative Coggins test is required for Department R ring fee @ $2.00 per class
entry into any class. A copy MUST be provided before
show date.
Exhibitors Pass @ $35 each ( 2 0NLY)
City and Zip: _______________________________
Premise Identification #: _______________________
Name: ____________________________________
Phone: ____________ SS#: ___________________
In person registration will be June28, 2017 from 68:30pm at the Fairgrounds
FOR OFFICE USE ONLY
Exhibitor Number: ___________________________
Pre-registration is required. Deadline is June 28, 2017
Department
Premium Number
$ __________
$ __________
Total Amount
$ __________
Make checks payable to MONROE COUNTY FAIR ASSOCIATION.
Mail entries and checks to:
Monroe County Fair Assn., PO Box 189, Waterloo, IL 62298
NO FAXED ENTRIES WILL BE ACCEPTED
Horse Name