Equine Payment Form

First Name: Enter the first name of the person this payment is for.

Last Name: Enter the last name of the person this payment is for.

Track or Commission Affiliation

Phone Please use ###-###-####

Email

Street Address

Street Address 2

City

State

Zip Code

Country

Please choose one of the following: Type of Accreditation

Flat
Harness

Payment For:

$80.00 - Both Days, registered before Dec 3, 2021
$40.00 - Monday, Dec 13th only, registered before Dec 3, 2021
$40.00 - Tuesday, Dec 14th only, registered before Dec 3, 2021
$100.00 - Both Days, registered after Dec 3, 2021
$50.00 - Monday, Dec 13th only, registered after Dec 3, 2021
$50.00 - Tuesday, Dec 14th only, registered after Dec 3, 2021

Payment Type

Credit Card
Check

The UofL hosted VIRTUAL ROAP Steward/Judge Continuing Education Program, December 13 – 14, 2021.