2017-2018 RODEO ENTRY FORM - ahsra.com

1 ARIZONA HIGH SCHOOL RODEO ASSOCIATION. 2017 - 2018 RODEO ENTRY form . Membership # _____ contestant Name: _____. Mailing Address: _____. City State Zip Phone #: (____)_____Email: _____Date of Birth: _____ Year: FR SO JR SR. High School _____Phone # (_____)_____. Name of RODEO you are entering: _____ Date{s} of Rodeo_____. Boys Events_____ Sat Sun Girls Events Sat Sun Calf Roping . $30 ___ ___ Barrel Racing $30 ___ ___. Steer Wrestling $30 ___ ___ Breakaway Roping .. $30 ___ ___. Saddle Bronc Riding .. $52 ___ ___ Goat Tying . $30 ___ ___. Bareback Riding . $52 ___ ___ Pole Bending $30 ___ ___. Bull Riding * $52 ___ ___ Cutting $45 ___ ___.

2 Team Roping .. $30 ___ ___ Header / Heeler Team Roping . $30 ___ ___. Reined Cow Horse .. $60 ___ ___ (circle one) Reined Cow . $60 ___ ___. Cutting .. $45 ___ ___ Queen Contest (finals only) $50. * INDUSTRY STANDARD HELMETS ARE REQUIRED FOR BULL RIDING. Team Roping Partner's Membership #_____Name_____ Header/Heeler (circle one). Team Roping Partner Needed _____ Header/Heeler (circle one or both). Please mark the events you are entering. Be sure to include Membership Numbers JUDGES FEES must be paid by all contestants $ ($ 5 per day). OFFICE FEE must be paid by all contestants $ ($13 per day). ASSOCIATION FEE must be paid by all contestants $ ($13 per day).

3 TOTAL DUE: $_____. contestant 's Signature: _____. Entries and money are due and must be postmarked (no metered mail) two weeks (15 days) prior to the first day of the RODEO . It is your responsibility to submit both sides of Official ENTRY form for all High School Rodeos on time with all proper signatures, notaries, membership numbers, and money. Entries postmarked less than 10 days from day of RODEO will not be accepted. A Fee of $ will be assessed for all late or incomplete entries. NO EXCEPTIONS! Draw out time is 48 hours before the RODEO with a charge of $ No refunds after 48 hours unless a doctor's or veterinarian's release is submitted with official signature on official letterhead by 6:00 of the day following the RODEO .

4 The secretary must be notified before the end of the RODEO that a medical release is coming. There will be a $25 returned check fee and you will be required to enter with a money order or cashier's check at all future rodeos. National and State membership applications and dues must be submitted to the RODEO Secretary, Marsha Collier, on or before the ENTRY deadline or 15 days before the first RODEO entered. Mail entries to: AHSRA. RODEO Secretary Marsha Collier Cell Phone: (928) 308-1301. Box 5039 website: Chino Valley, AZ 86323. E-mail: Please make checks payable to: AHSRA. Waiver of Liability We, the parents of _____ ( contestant ) give the nearest hospital permission to administer NECESSARY EMERGENCY treatment for injuries he or she may incur while participating in the _____High School RODEO .

5 We understand that each contestant must be and is covered by medical insurance. We hereby release the Hospital, physicians on the Medical Staff, the RODEO Sponsors and the Stock Contractors from all liability. We also do hereby release and discharge the Arizona High School RODEO Association, its officers, agents and employees from any and all claims, demands, damages, suits, actions or causes of actions which may or can be suffered by said son or daughter while participating in the said High School RODEO . This release is complete and full and is not contingent upon any act, work, or deed by either the undersigned or the sponsoring bodies and individuals of said RODEO .

6 _____ or _____. Father's signature Mother's signature _____ _____ ___. Mailing Address City, State, and Zip Subscribed and sworn to before me this _____ day of _____, _____. _____. Notary Public Certificate of Eligibility I, the undersigned, do hereby certify that _____, name of student, is enrolled in _____High School, has made passing grades in at least 70% of the classes taken and meets conduct qualification. (This eligibility can be signed up to one week before the ENTRY due date of the RODEO , but no sooner, you must be eligible on date the form is signed.). Dated this _____day of _____, _____. _____ _____.

7 Signature of School Official Position or Title BOTH SIDES OF ENTRY form MUST BE COMPLETED FOR EACH RODEO even if you are 18 years old.