Jumper Test

Name of Rider*

First Last

Age*

Junior (under 18)
Senior (18+)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Horse Name*

Parent/Guardian Name*

First Last

Fees

Select Your Level*

Pre-Elementary 3 phase ($100)
Elementary 3 phase ($100)
Advanced Elementary 3 phase ($100)
Beginner Novice 3 phase ($100)
Novice 3 phase ($100)
Training 3 phase ($100)

Tests

Introductory B Dressage Test ($35)
Beginner Novice A Dressage Test ($35)
Beginner Novice B Dressage Test ($35)
Novice B Dressage Test ($35)
Training B Dressage Test ($35)

Extra Jumping Round

18" Extra Jumping Round ($25)
2'0" Extra Jumping Round ($25)
2'3" Extra Jumping Round ($25)
2'7" Extra Jumping Round ($25)
2'11" Extra Jumping Round ($25)

Boarding

Overnight Stall ($60)
Day Stall ($30)

Payment -- Level

Pay $100 for selected level
Pay by check

Pay by credit card now or mail a check, payable to Stoneleigh-Burnham School, with a printed copy of this entry form. Send checks to: Stoneleigh-Burnham School, attn: George Halkett, 574 Bernardston Road, Greenfield, MA 01301. Incomplete entries will not be considered.

Payment -- Test

Pay $35 for selected test
Pay by check

Pay by credit card now or mail a check, payable to Stoneleigh-Burnham School, with a printed copy of this entry form. Send checks to: Stoneleigh-Burnham School, attn: George Halkett, 574 Bernardston Road, Greenfield, MA 01301. Incomplete entries will not be considered.

Payment -- Extra Jumping Round

Pay $25 for selected jumping round
Pay by check

Pay by credit card now or mail a check, payable to Stoneleigh-Burnham School, with a printed copy of this entry form. Send checks to: Stoneleigh-Burnham School, attn: George Halkett, 574 Bernardston Road, Greenfield, MA 01301. Incomplete entries will not be considered.

Payment -- Boarding

Pay $60 for Overnight Stall
Pay $30 for Day Stall
Pay by check

Pay by credit card now or mail a check, payable to Stoneleigh-Burnham School, with a printed copy of this entry form. Send checks to: Stoneleigh-Burnham School, attn: George Halkett, 574 Bernardston Road, Greenfield, MA 01301. Incomplete entries will not be considered.

Total

$ 0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Stoneleigh-Burnham Equestrian Registration

Fees