CIRCLE DIVISION TO ENTER: (Rider's age is as of Jan. 1, 2011)
| Lead-Line | Walk-Trot | Novice (Slow Lope) | 12 & Under | 13 to 17 | 18 to 39 | 40 & Over |
RIDER NAME: ________________________________________ BRR MEMBER? _____ YES or _____ NO
CITY:_________________________________ STATE:________ PHONE:___________________________ EMERGENCY CONTACT PHONE: ___________________________ RIDER'S AGE ON JAN. 1st, 2011:___________| 1. Cloverleaf Barrels | 2. Fig.8 Cowhorse | 3. Big "T" | 4. Pole Bending |
| 1. Cloverleaf Barrels | 2. Fig.8 Cowhorse | 3. Big "T" | 4. Pole Bending |
| 1. Cloverleaf Barrels | 2. Fig.8 Cowhorse | 3. Big "T" | 4. Pole Bending |
TOTAL GYMKHANA EVENTS __________ @ $5.00 EACH = _____________
TOTAL BARREL TIME ONLY'S __________ @ $2.00 EACH = _____________ NON-MEMBER FEE @ $5.00 PER RIDER = _____________ TOTAL FEES* $ ________________ PAID: CASH _________ or CHECK # _________THIS MUST BE SIGNED IN ORDER TO RIDE!
I have read the rules and agree to abide by them or be disqualified. I agree that the Bear River Riders; the officers, board members, volunteers, property owners, horse owners, and sponsors will not be held responsible for any injury or accident to me, my family, my livestock, or my possessions.
I HAVE READ THE ABOVE; AGREE AND UNDERSTAND IT FULLY.
SIGNATURE _____________________________________ DATE_________ *All returned checks are subject to a $25 fee.
(Parent or Guardian if under 18)