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2015 National O-Mok-See Johnson County Fair & Rodeo Grounds 18 Fairgrounds Road Buffalo, Wyoming 82834 July 18th thru July 24th Name: (Please Print) ______________________________________________________ Address: ______________________________________________________ City/State/Zip: ______________________________________________________ Phone: ______________________________________________________ E-Mail Address: ______________________________________________________ Saddle Club: ______________________________________________________ Stalls Dates Reserved only 90 covered stalls available No Tack Stalls Pens Camping Thursday, July 16th Friday, July 17th Sat., July 18th – Sat., July 25th Geldings/Mares Studs Available For 2-4 Horses # of Horses per pen Thursday, July 16th Friday, July 17th Sat., July 18th – Sat., July 25th Dry Camping Camping with Electric Number Reserved ________ ________ Cost per Stall/Horse X $15 X $15 ___________ ___________ ________ ________ X $60 X $60 ___________ ___________ ________ ________ ________ X $60 X $15 X $15 ___________ ___________ ___________ ________ ________ X $90 X $105 ___________ ___________ Motor Home/Trailer Size __________ feet TOTAL DUE Total ___________ All Horses brought to the National Championship O-Mok-See Must be stalled. No horse shall be tied to a trailer overnight. A vendor with shavings will be available at the fairgrounds. Shavings NOT provided with stalls! • A $25 late fee will be assessed to each stall/camping reservation payment received after June 4th, 2015. • All camping and stalls will be assigned by NSCA board on first paid basis. • All stalls & pens must be thoroughly cleaned before departure, if you choose to not clean your stalls, NSCA will bill you $50 per stall or pen that needs to be cleaned. PLEASE SUBMIT RESERVATIONS TOGETHER , IF YOU WISH TO BE STALLED OR CAMPED NEAR SOMEONE. Send Reservation Form and Payment in Full to: Scott Galloway, 13530 W. 109th St. N., Sedgwick, KS 67135 (Make Checks/Money Orders payable to NSCA) All returned checks will be assessed a $30 fee. All fees are non-refundable unless vet release or medical release is provided TOTAL AMOUNT SUBMITTED: CHECK # DATE RECEIVED AMOUNT $ QUESTIONS ON STALLS & CAMPING CALL: Scott Galloway 316-619-6290 or Asa Galloway 316-619-6289