California High School Rodeo Association s1

California High School Rodeo Association - District 2

DATE: December 4, 5 & 6 , 2009 Location: Lakeport, CA. (Lake County Fairgrounds)

Entries Close: November 25th , 2009 MUST BE POSTMARKED BY CLOSING DATE!

Limited Stalls Available, reserved first come first served.

CONTESTANT NAME:______

Friday Cutting: check in 2 pm, cutting 3pm Mail Entries to:

Saturday CHECK IN: 7:00 to 8:00 am Stephanie Wheeler

Rodeo: Saturday 9am Sunday 9 am

P.O. Box 847

Laytonville, CA 95454

(707) 272-3283Rodeo Entry Questions

Please place a check mark next to the event you wish to enter

Total Event Fees

TOTAL FEES

____ Bull Riding ($68) ____Pole Bending ($25)

____ Bareback ($68) ____Barrel Racing ($25)

____ Saddle Bronc ($68) ____Breakaway ($45)

____ Tie Down Roping ($45) ____Goat Tying ($25)

____ Steer Wrestling ($45 ____Girls Cutting ($45)

____ Boys Cutting ($45) ____ Team Roping ($45)

ROPERS: PLEASE indicate

are you a Header or Heeler Checks payable to: CHSRA Dist.2

Partners Name______Garbage bags will be handed out for

Are you interested in being a ghost roper yes or no incorrect or incomplete entries!

Name of High School

For School Official Validation:

“I do certify that this student meets both NHSRA Grade and Conduct qualifications (Must have passing grades in minimum of 4 classes, if carrying less than 4 classes, must have passing grades in all) AND CHSRA Requirements, which are: student has at least a 2.0 GPA as of the latest “GRADING PERIOD” (Grading Period must cover 6 weeks or more) (Grading Period: Quarter, Semester, or “Progress Reports” mailed home that are generated 6 weeks or more with ALL current grades and mailed to ALL students) (No “walk around” grades accepted!)

Student must be in good standing; not ruled undesirable for misconduct at school.

ÞSIGNED: Date: PHONE #

Principal or Counselor (Place School Stamp or Seal over Signature)

*Set-ups: Form on the back of this sheet. All set-up forms must accompany rodeo entry. Form must be completed in its entirety including signed and stamped by school.

*NO LATE ENTRIES WILL BE ACCEPTED

(all entries will be returned unopened if postmarked after due date)

*Membership cards required at check-in

*Contestants must be C.H.S.R.A. member in good standing

THE RELEASE BELOW MUST BE COMPLETED AND RETURNED WITH ENTRY FORM

“We the parents or guardians of (name of contestant) give the Sutter Lakeside Hospital) and physicians on the medical staff of the Hospital, permission to administer Necessary Emergency treatment for injuries he/she may incur while participating in the CHSRA District #2 Rodeo. We understand that each contestant must be and is covered by medical insurance. We hereby release the Sutter Lakeside Hospital), its physicians on the Medical staff and the Rodeo Sponsors from all Liability.”

We the undersigned hereby release the Lake County Fairgrounds, City of Lakeport, West Coast Rodeo Company; its officers and employees; all members of CHSRA, and any and all persons associated with the above said Rodeo from all liabilities, losses or damages to rider or property.

è  SIGNED:

(Parent or Guardian Must Sign, regardless of age of contestant)

è Contestant Signature _____ Membership # District#_____

Address City ____ Zip

Telephone - Grade Age

List NEW sponsors since last rodeo: ______

SET-UP FORM

(Only fill out if you need a set-up for this rodeo, both places must be signed & stamped)

Reason for Rodeo Set-up: ______Date of School Function: ______

School Contact and Phone No.: ______

Signature of: School Athletic Director (for High School Team Sports Function) OR Principal or Counselor (if test or other School Related Function) MUST place School Seal or Stamp Over Signature

Signature: ______(Signature of Principal or Relevant School Official)

*Contact name at school must be completed. *Set-ups are for high school functions only.

He/She will be contacted by the rodeo secretary to verify function and date

Contestant must be a valid member of a school team, contest or test activity occurring on the date of this rodeo.

*Set-ups are for Saturday (or 1st go): meaning both goes run on Sunday or 2nd go.*Sunday set-ups will be accepted only if there are no contestants needing a Saturday set-up.*Set-ups will be run prior to the start of the 2nd go round. Stock and positions will be drawn for set-ups just the same as other contestants