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Video Order Form
Congress Video Order
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Congress Video Order Form
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*
" indicates required fields
Name of person Placing Order
*
First
Last
Phone
*
Email
*
For the online choice this is the email address your video link will be sent to.
Address
Required if you are ordering a video that will require shipping (USB)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
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Indiana
Iowa
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Louisiana
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Maryland
Massachusetts
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Northern Mariana Islands
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U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Congress Year
*
2024
2023
2022
2021
2019
2018
Delivery Method
*
Pattern Class Online Video (YouTube or similar online service)
Pattern Class Video on USB Thumb Drive (requires thumb drive)
Rail Class Online Video (YouTube or similar online service)
Rail Class Online Video on USB Thumb Drive (requires thumb drive)
Speed Class Online Video (YouTube or similar online service)
Speed Class Online Video on USB Thumb Drive (requires thumb drive)
Quantity
*
Plesae indicate the number of videos you are ordering.
Please enter a number greater than or equal to
1
.
USB Thumb Drive
*
Price:
Name Of Rider
*
First
Last
Arena
*
Celeste
Coliseum
Cooper
Class Type
*
Pattern Class
Rail Class
Speed Class
Class Name
*
Date of Ride
*
MM slash DD slash YYYY
Draw# or Split#
Back Number
*
Additional Comments
If ordering more than 1 run at a time please be specific here. Include the Date, Name of Rider, Back #, Draw #, Arena or anything else that may help us identify the correct ride. Also be sure to increast the quantity being ordered.
Payment Method
*
Only select "Cash or Check" if you are at the show and plan on paying the day you place an order online. Orders will not be processed until paid. Our booth is in the Celeste next to Shane Rux Photography.
Credit Card
Cash or Check
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First
Last
Email
*
Phone
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Message
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