*CONTESTANT:______CARD #______
Address:______City______Zip______
Telephone:______Email______
CHSRA Junior Division District 9
RODEO DATE: October 28th, 2017 ENTRY DEADLINE: Must be postmarked by Saturday, October14, 2017
Jr. Rodeo #3 RAIN DATE:November 4, 2017
PLACE: Tehachapi Event Center and Rodeo Grounds
Dennison Rd and Hwy 58, Tehachapi, CA
CHECK IN: Sat. 7:00 AM – 7:30 AM GROUND RULES: 8:00 AM GRAND ENTRY: 8:30 AM Saturday
START: Rodeo Begins at 8:30 AM Saturday
MAIL COMPLETED ENTRY ALONG WITH A CHECK TO: CHSRA District 9
SeannaInderbieten, 2211Cheyenne Dr, Bishop,CA 93514
BOY’S EVENTS / FEE / PAID / GIRL’S EVENTS / FEE / PAIDJR. BARE BACK STEER RIDING / $37 / BARREL RACING / $27
JR. SADDLE BRONC STEER RIDING / $37 / POLE BENDING / $27
JR. BULL RIDING / $37 / GOAT TYING / $30
TIE DOWN ROPING / $30 / BREAKAWAY ROPING / $30
OR BREAKAWAY / $30
GOAT TYING / $30 / RibbonRoping(circleone)Roper/Runner / $30
CHUTE DOGGING / $30 / Name of Partner:
RibbonRoping(circleone)Roper/Runner / $30 / Ghost Ribbon Roper—Need a Partner / $35
Name of Partner / Circle one needed—Roper/Runner
Team Roping(circle one) Header/Heeler / $30 / Team Roping(circle one) Header/Heeler / $30
Name of Partner / Name of Partner
Need Ghost Roping Partner / $35 / Need Ghost Roping Partner / $35
*Mandatory Office Fee / $25 / *Mandatory Office Fee / $25
TOTAL / TOTAL
Do you want to volunteer to be a team roping ghost draw partner? YES or NO Header or Heeler
ROOKIE: YES / NO
NOTE: $5 of the entry fee for each event goes toward Jackpots for that event.
Release of Liability and Medical Authorization
We, the parents or guardians of______,give the Tehachapi Valley Hospital and the Physicians on the Medical Staff of the hospital permission to administer NECESSARY EMERGENCY treatment for injuries he/she may incur while participating in the District 9 High School /Jr. High School Rodeo. We understand that each contestant must be and is covered by medical insurance. We hereby release the Tehachapi Valley Hospitalphysicians on the Medical Staff, and the Rodeo Sponsors from all liability.
______
Contestant’s Signature Parent or Legal Guardian Signature
SCHOOL VALIDATION
The undersigned certifies that this student meets NHSRA & CHRSA grade and conduct qualifications of passing grades in a minimum of 4 classes or if carrying fewer than 4 classes, passing grades in all AND a minimum of 2.0GPA as of the last grading period(five weeks or more). Grading period is defined as quarter, semester or interim progress report that is mailed home with all current grades and given to all students (no “walk around” grades accepted). Student is in good standing and has not been ruled undesirable for misconduct at school.
______
Signature & Title (Principal or Counselor)Date Phone
Please Place School Seal or Stamp Over Signature: *ENTRY WILL NOT BE ACCEPTED WITHOUT ONE!