NCDCTA Eventing MEDAL Form
To send eventing medal scores for HOY points to the Membership Secretary, please fill out the following form in it's entirety and press the Send button. PLEASE SEND THE FORM ONCE ALL THREE SCORES HAVE BEEN EARNED.
All Fields are REQUIRED.

Rider Name:

NCDCTA Rider Number:

Horse Name:

NCDCTA Horse Number:

Owner Name:

NCDCTA Owner Number:

Rider Phone:

Rider Email:

First Event Name:

First Event Date:

First Event Location:

First Division:

First Place: First Score:

Second Event Name:

Second Event Date:

Second Event Location:

Second Division:

Second Place: Second Score:

Third Event Name:

Third Event Date:

Third Event Location:

Third Division:

Third Place: Third Score: