District 7 High School Rodeo High School First Half Season Rodeo Entry Form 2015 CONTESTANT NAME: _____________________________________________________________________________________________ ADDRESS: ____________________________________________________________ CITY: _____________________________ STATE: ______________________________ ZIP: _______________ AGE: __________ GRADE: __________ PHONE: ( _____ ) ________________________ CLUB & SCHOOL: ________________________________________________ EVENT Box MUST be checked next to event to be considered a valid entry April 17th Rodeo Entry 1 Fee April 18th Rodeo 2 Entry Fee April 24th Rodeo Entry 3 Fee April 25th Rodeo Entry 4 Fee May 1st Rodeo Entry 5 Fee May 2nd Rodeo Entry 6 Fee BAREBACK (H S Only) $21.00 $21.00 $21.00 $21.00 $21.00 $21.00 SADDLE BRONC (H S Only) $21.00 $21.00 $21.00 $21.00 $21.00 $21.00 BULL RIDING (H S Only) $21.00 $21.00 $21.00 $21.00 $21.00 $21.00 TIE DOWN ROPING (H S Only) $17.00 $17.00 $17.00 $17.00 $17.00 $17.00 STEER WRESTLING (H S Only) $17.00 $17.00 $17.00 $17.00 $17.00 $17.00 BARREL RACING $15.00 $15.00 $15.00 $15.00 $15.00 $15.00 POLE BENDING $15.00 $15.00 $15.00 $15.00 $15.00 $15.00 GOAT TYING $17.00 $17.00 $17.00 $17.00 $17.00 $17.00 BREAKAWAY ROPING $17.00 $17.00 $17.00 $17.00 $17.00 $17.00 TEAM ROPING $17.00 $17.00 $17.00 $17.00 $17.00 $17.00 CHECK ONE for Team Roping PARTNER Name: _____________________________________ I AM THE HEADER REINED COW HORSE Fees : $80.00 April 13 & 14 QUEEN CONTEST (Grades 9 thru 11) Fees: $20.00 March 27 & 28 Entry Fees Paid by: Cash ( ) Check # __________ Fees Rodeo 1 Fees Rodeo 2 Fees Rodeo 3 Fees Rodeo 4 Fees Rodeo 5 Fees Rodeo 6 ( ) Fees Cutting HEELER Fees Queen ( ) Total Due $ 0.00 1ST HALF ENTRIES MUST BE TO YOUR ADVISOR NO LATER THAN APRIL 4th, 2015 You cannot be drawn into a rodeo if your fees are not paid on time!!!! 2nd HALF ENTRIES MUST BE TO DISTRICT 7 RODEO SECRETARY NO LATER THAN APRIL 25th. Include cash, check, or money order made payable to: DISTRICT 7 HIGH SCHOOL RODEO Each rodeo is a separate performance so you don't have to enter both on a week-end. We have two rodeos per week-end. There are NO preferred performances with the exception of your own graduation. If you need a preferred performance for your graduation check here __________. There is a chain of command that MUST be followed. Read the NHSRA Rule Book for details. You should also read the NHSRA Rule Book for general rules and the rules of your events. We as parents or guardians and as a participant agree to follow the NHSRA Rules as outline in the NHSRA Rule Book and ALL ground rules set by the State of Idaho High School Rodeo and District 7 High School Rodeo. If we do not follow the outlined rules this could result in probation or suspension from District 7 High School Rodeo. Parent or Guardian Signature Contestant Signature Parent or Guardian Signature Date: PARENT OR GUARDIAN MUST SIGN THE FOLLOWING STATEMENT. I the undersigned parent or legal guardian of _____________________________________________ do hereby release Idaho District 7 High School Rodeo, the host committee thereof, and any and all sponsoring groups, organizations and individuals from all responsibility and liability for any and all injuries or disablements of any kind or nature whatever, suffered or inflicted through my son’s/daughter’s participation in Idaho District 7 High School Rodeos held at the Madison County Fairgrounds, Rexburg, Idaho 83440, Rigby Rodeo Grounds, Rigby, Idaho 83442, Freomont County Fairgrounds, St. Anthony, Idaho 83445, and Tetonia Arena, Tetonia, Idaho. I agree to completely release the above- named parties from any and all responsibility and liability for all injuries to person or livestock, or damage to or theft of equipment. I agree that all the risks related to the above-named hazards and any other are expressly assumed. Signature of Parent or Guardian MEDICAL RELEASE I, the undersigned parent or legal guardian of do hereby give the Madison Memorial Hospital, the Eastern Idaho Regional Medical Center, or Teton Valley Medical Center and the physicians on the medical staff of the hospital permission to administer necessary emergency treatment of injuries he or she may incure while participating in any Idaho District 7 High School Rodeo Events. I understand that each contestant must be and is covered by medical insurance. I hereby release the Madison Memorial Hospital, Eastern Idaho Regional Medical Center, or Teton Valley Medical Center, physicians on the medical staff and the rodeo sponsors from all liability, except for negligence. Signature of Parent or Guardian
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