Memphis Futurity/Derby Pedigree Form

Unique ID

Rider Name

First Last

Rider Address*

Street Address City State ZIP Code

Rider Phone

Owner Address*

Street Address City State ZIP Code

Owner Phone

* Regular entry form required in addition to this pedigree form * All Breeder’s Challenge Futurity & Derby Entries must enter through Breeder’s Challenge & ARE REQUIRED to either carry over to the Lucky Dog Futurity or Derby OR carry over to BOTH Thursday & Friday Open races

Horse's Registered Name

Select appropriate event*

FUTURITY
DERBY

Year Foaled*

Please enter a number from 2013 to 2020.

Sex*

Stallion
Gelding
Mare

Breeders Challenge*

Yes
No

Sire*

Dam*

Dam's Sire*

Copy of Registration Papers Required! Please submit with entry.

Max. file size: 256 MB.

understand that every effort will be made to ensure the safety of each contestant and his/her horse(s). I hereby release Lucky Dog Productions, Agricenter Showplace Arena and all sponsors involved. I also acknowledge that I have read, understand, and agree to abide by the rules of Lucky Dog Productions and any ground rules enforced for specific events

Release Agreement*

I have read and agree to the release of liability.

Futurity & Derby Pedigree Form