Labor Day Jackpot Rodeo August 30th , 2008 9:30 AM / Office Use Only
Check Number
Amount Paid
Amount Due
Owed
Entries must be post-marked by August 30th, 2008, and sent to:
NU Roping Club c/o Kathy Airheart, 100 S C Ave, New Underwood, SD 57761
Email: Forms at: www.newunderwood.com
NU Roping Club telephone: 441-7096 Please leave a message.
Parent’s signature is required for all minors
Girls and Boys 8 & Under $5.00 per event□ Barrel Race / ______/ □ Ribbon Snatching / ______
□ Pole Bending / ______/ □ Flag Race / ______
Girls Age 9 to 11 $10.00 per event / Boys Age 9 to 11 $10.00 per event
□ Barrel Race / ______/ □ Barrel Race / ______
□ Pole Bending / ______/ □ Calf Riding / ______
□ Goat Tying / ______/ □ Goat Tying / ______
□ Flag Race / ______/ □ Flag Race / ______
Girls Age 12 to 14 $10.00 per event / Boys Age 12 to 14 $10.00 per event
□ Barrel Race / ______/ □ Flag Race / ______
□ Pole Bending / ______/ □ Bull Riding / ______
□ Goat Tying / ______/ □ Goat Tying / ______
□ Break Away Roping / ______/ □ Break Away Roping / ______
Girls Age 15 to 17 $10.00 per event / Boys Age 15 to 17 $10.00 per event
□ Barrel Race / ______/ □ Bronc Riding * * / ______
□ Pole Bending / ______/ □ Bull Riding / ______
□ Goat Tying / ______/ □ Calf Roping / ______
□ Break Away Roping / ______/ □ Flag Race / ______
Women 18 & Over $10.00 per event / Men 18 & Over $10.00 per event
□ Barrel Race / ______/ □ Bronc Riding * * / ______
□ Pole Bending / ______/ □ Bull Riding / ______
□ Goat Tying / ______/ □ Calf Roping / ______
□ Break Away Roping / ______/ □ Flag Race / ______
Open To All $10.00 per event
□ Crepe Paper Race / ______/ Partner’s Name: / ______
Name: ______
Address: ______/ Entry Total: / ______
City, State, Zip: ______/ Surcharge: / $ 5.00
Phone: ______DOB: ______Age on 1/1/08: _____ / Total: / ______
* * Contestants option to use bareback or saddlebronc rigging will be scored the same.
Jackpot money paid to the top 4 places. All-Around buckles for all 5 age groups. 4-H rules will be used as a guideline only with the interpretation and application left to the discretion of the rodeo committee. Decision of the judges will be final. Contestants can move up in age group competing for prize money only, no points will be awarded except in your own age group. The wearing of protective gear is recommended, but not required of the contestant.
Parents or Guardians Agreement of Waiver of Liability,
Indemnification and Medical Release
Under South Dakota Law, equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risk of equine activities, pursuant to SDCL 42-11-1.
The undersigned parent and natural guardian or legal guardian does hereby acknowledge that he/she is aware of the dangers involved in participating in 4-H Rodeo; and that rodeos are dangerous and will expose him/her to substantial and serious risk of property damage and/or personal injury or death.
Said undersigned parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees on behalf of the participant and his/her executors, administrators, heirs, next-of-kin, successors and assigns to:
a. Waive, release and discharge from any and all liability for participant’s death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to participant and his/her estate, the State of South Dakota, and its officers, agents, employees, 4-H volunteers, stock contractors, arena owners and arena officials; and
b. Indemnify and hold harmless the State of South Dakota, and its officers, agents, employees, 4-H volunteers, stock contractors, arena owners and arena officials from and against any and all liabilities and claims made by other individuals or entities as a result of participant’s participation or actions during this activity or event.
The undersigned further consents to and authorizes medical treatment to the participant, which may be deemed advisable in the event of injury, accident or illness during this event. The undersigned further understands that he/she is financially responsible for any such medical treatment. This release waiver shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I, the undersigned, acknowledge that I have read and understand the above RELEASE.
Name of Minor: ______DOB ______
Minor’s Signature ______Date: ______
Name of Parent or Guardian: ______
Parent’s or Guardian’s Signature: ______
Notary Acknowledgement
Subscribed and sworn by ______(parent/guardian) before me this ______day of ______, 20____
Seal:
Notary’s Name: ______
My Commission Expires: ______