20th Annual5-State Breeders Futurity
OPEN 2D POLE BENDING FUTURITY ENTRY FORM
Friday July 21st, 2017 at 2:30pm
Registered Name of Horse: Click or tap here to enter text.
Stallion ☐ Gelding ☐ Mare ☐
Sire: Click or tap here to enter text.
Owner / Rider ☐check here if the sameName(s) / Click or tap here to enter text. / Click or tap here to enter text. /
Address / Click or tap here to enter text. / Click or tap here to enter text. /
Phone / Click or tap here to enter text. / Click or tap here to enter text. /
Email / Click or tap here to enter text. / Click or tap here to enter text. /
I (we) hereby make application to enter the above named horse in the 5-State Breeders Futurity. I (we) agree that ALL 5-State Breeders Barrel Futurity decisions are to be FINAL. I (we) hereby release the above 5-State Breeders Barrel Futurity, LI Productions LLC, futurity co-sponsors, and the Central States Fairgrounds from any claim or loss to myself, rider, employee, horses and/or equipment.
Signature (parent if minor) ______DateClick or tap to enter a date.
Check to be writtento ☐Owner ☐Rider Everyone receiving a check must have a W-9 on file in the office.
W-9 will be mailed if you receive a check and are not present.
$60 payment due July 1st, 2017
Late entries taken with $20 late fee until 12pm Friday July21st.
Mail checks and entries: LI Productions, LLC P.O. Box 296 Beulah, WY 82712
INCLUDE FRONT AND BACK COPY OF PAPERS WITH ENTRY
contact LI Productions, LLC - or (605)431-9480
exhibition and stalling forms available on
ALL – AROUND BUCKLE AWARDED TO HIGH POINT BARREL AND POLE FUTURITY HORSE
Sponsored by Gary Westergren
5-State Open Pole Bending Futurity Rules5-State Open Pole Bending Futurity Pole Bending Futurity
$500 added and prizes
1. The Futurity is open to horses that are four or five years old. Horses must not have reached the age of six by the time of Futurity. To be eligible for the Futurity, the horse must NEVER have competed in ANY pole bending, including AQHA shows, playdays, novice horse events, derbies, rodeos, etc. prior to December 1, 2015. To do so means forfeit of any and all fees paid and elimination from the futurity. However, horses may have competed anywhere after December 1, 2016.
2. There will be one go-round.
3. $60 entry fee - pre-entries close on July 1st, 2017. Late entries accepted until 12pm July 21stwith $20 late fee and will run at the end.
4. 1.5 second split - progressive payout