Stallion Name_______________________________________________________________________________________________________________

Owner/Lessee________________________________________________________________________________________________________

Address_____________________________________________________________________________________________________________

City _________________________________________________ State __________ Zip _________ Phone_____________________________

                                    $125 Stallion Listing Fee Due NOVEMBER 30, 2009
                        $250 Stallion Listing Fee Due DECEMBER 1 THRU DECEMBER 31, 2009
            $375 Stallion Listing Fee Due JANUARY 1, 2010 until the 2010 Weanling Futurity

The Oregon Paint Horse Breeders/Triple Crown Futurities will not be responsible for any accident that may occur to any exhibitor, equipment, or horses. Signing of this form waives any and all claims against the OPHB/TCF or the management of any of their sponsored futurities. In signing this form, the undersigned acknowledges that they have read and agree to abide by the rules and regulations of the OPHB/TCF.

STALLION LISTING FEE PAID BY ANYONE OTHER THAN THE STALLION OWNER/LESSEE REQUIRES STALLION OWNER/LESSEE PERMISSION IN WRITING.

Signature of Owner/Lessee_______________________________________________________Date_____________________

Rec’d By _____________________________________________ Amount ____________ Check# ____________ Date______________________