QSLB Dressage Entry Payment Form

Thank you for Registering, please complete this form to make your payment ONLY AFTER you have registered for your Entry in one of our Bronze, Silver or Gold shows.

First Name*

Last Name*

Email Address*

Phone*

Horse Name:*

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Fees and Dues

Please enter the exact amount owning, as provided by QSLB, in order to complete your registration for this event.

Amount Owning: $*

Comments

Payment Type

Credit Card using PayPal Interac / e-Transfer

Total

Enter the code displayed*