5Th District Finals Jerome High School Rodeo Entry Form

5TH DISTRICT JEROME FINALS JUNIOR HIGH #6 RODEO ENTRY FORM

MAY 23, 2015 SATURDAY 12:00 P.M

ENTRIES CLOSE MAY 9, 2015

NAME OF CONTESTANT______

ADDRESS TOWN AGE______

SCHOOL GRADE PHONE NO. ______

MONEY MUST ACCOMPANY YOUR ENTRY FORM AND PAYABLE TO DISTRICT 5 RODEO ASSOCIATION

YOUR ENTRY MUST BE IN THE HANDS OF THE DISTRICT SECRETARY BY CLOSING DATE.

LATE ENTRIES WILL NO BE ACCEPTED!!!!!!!!

MAIL ENTRIES TO: LU ANN SWAINSTON P.O. BOX 163 RICHFIELD, IDAHO 83349 208 487-2306 OR 539-2306 CELL

WORK 487-2755 EMAIL

CHECK THE EVENTS YOU WANT TO ENTER

BOYS EVENTS SATURDAY GIRLS EVENTS SATURDAY

CALF ROPING OR $12 00 ______BARREL RACING $12.00 ______

BREAKAWAY ROPING $12.00 ______POLE BENDING $12.00 ______

CHUTE DOGGING $12.00 ______GOAT TYING $12.00 ______

BULL RIDING $12.00 ______BREAKAWAY ROPING $12.00 ______

BAREBACK $12.00 ______TEAM ROPING $12.00 ______

SADDLE BRONC $12.00 ______

GOAT TYING $12.00 ______I AM THE HEADER OR HEELER

TEAM ROPING $12.00 ______PARTNERS NAME______

I AM THE HEADER OR HEELER TOTAL DUE ______

PARTNERS NAME______

TOTAL DUE ______

WE THE PARENTS AND GUARDIANS OF (CONTESTANT NAME) GIVE ANY HOSPITAL, THE PHYSICIANS ON THE MEDICAL STAFF OF THE HOSPITAL, PERMISSION TO ADMINISTER NECESSARY EMERGENCY TREATMENT FOR INJURIES HE OR SHE MAY INCUR WHILE PARTICIPATING IN THE 5TH DISTRICT HIGH SCHOOL RODEO HELD ON THE GROUNDS OF ANY ARENA. WE UNDERSTAND THAT EACH CONTESTANT MUST BE AND IS COVERED BY MEDICAL INSURANCE. WE HEREBY RELEASE ANY HOSPITAL, PHYSICIAN ON THE MEDICAL STAFF, AND AMBULANCE SERVICE, RED CROSS OR EMT VOLUNTEERS AND THE RODEO SPONSORS FROM ALL LIABILITY EXCEPT FOR NEGLIGENCE.

MEMBERSHIP IN THE NJHRA BY THE STUDENT AND AS AUTHORIZED BY THE MOTHER, FATHER, OR GUARDIAN HEREBY GRANTS PERMISSION TO USE THE STUDENT’S NAME, PHOTOGRAPH, PICTURE, LIKENESS, AND PHYSICAL DEPICTION TO BE USED BY SUCH PERSONS, FIRMS, OR CORPORATIONS AS MAY BE APPROVED AND SELECTED BY THE NJHRA AND WILL ABIDE BY THE TERMS AND CONDITIONS OF ANY AGREEMENT BETWEEN THE NJHRA AND SUCH PERSONS, FIRMS OR CORPORATIONS REGARDING ADVERTISING AND PROMOTIONAL ISSUES.

Parents and Contestants—Please Read and Sign: All contestants are required to read the rules carefully, particularly those relating to the event in which they enter. Failure to understand rules will not be accepted as an excuse. I/We understand that failure of the contestant or his/her parents to follow the chain of command, or violation of any NHSRA ground rule may result in probation for the contestant or immediate disqualifications of the contestant.

STUDENT AND PARENT/GUARDIAN MUST SIGN THE ENTRY FORM

______DATE______

CONTESTANT SIGNATURE

______DATE______

PARENT/GUARDIAN SIGNATURE