__________________________                    _____________________________

Name of Rodeo                                                                        Name of Contestant

__________________________                    _____________________________

Date of Rodeo                                                                          Complete Mailing Address

__________________________                    _____________________________

Location of Rodeo                                                                   City, State, Zip Code

__________________________                    _________________              _______

Social Security Number                                                             Telephone Number                                  Back Number

 

Check if One Time Only ___________$15.00 (Applies to Non- Members)

 

PARENTS MUST SIGN For each event you enter.


 

BOYS EVENTS:                                                                     GIRLS EVENTS:

Bareback Riding_____________________________         ($20)       Pole Bending___________________________________($10)

 

Steer Wrestling______________________________        ($20)       Goat Tying____________________________________ ($20)

 

Bull Riding__________________________________         $20)

 

Saddle bronc_________________________________        ($20)       Break Away Roping____________________________ ($20)

 

Calf Roping__________________________________       ($20)       Barrel Racing__________________________________($10)

 

Team Roping_________________________________        ($10)

 

I am the Header or Healer. My Partner’s name is________________________________

 

 Ground Fees _________________________________($20 for LAKEVILLE RODEO) Fee to be paid per family. If paid by another member in the family

 

Indicate contestants name and back number : ___________________________________________________        ___________

                                                                                (Family members Name)                                                        Back Number

 

Total Amount included with entry is: $__________________________(Includes ground fee) Make Checks payable to: MHSRA

 

Contestants Signature:_______________________________________________________________

 

***********************************************************************************************************

We, the parents or guardians of _________________________________________________(contestant’s name)

 

 Give the (local Hospital)______________________________ and physicians on the Medical Staff of the Hospital Permission to administer NECESSARY EMERGENCY treatment for injuries he or she may incur while participating in the

 

__________________________High School Rodeo. We hereby release the (local Hospital)______________________________, physicians on the Medical Staff, and the Rodeo Sponsors from all liability.

 

Signed:_______________________________________ and______________________________________________.

                (Requires Both Parents/Guardians Signatures)

                                                                                                                Subscribed and Sworn to me before this

 

                                                                                                                ___________day of ___________, _______

                                                                                                                                                                     (Year)

 

                                                                                                                Notary Public:_____________________________

 

 

                                                                                                                                                (Stamp here)

                                                                                                                My Commission Expires:___________________

**********************************************************************************************************

School Signature Required: 

 

I certify that this student meets                                                                                                         Entry Deadline:

National High School Rodeo                                                                                                               14 days prior to Rodeo

Association’s GRADE AND CONDUCT                                                                                              Draw outs:

Qualifications.                                                                                                                      24 Hours prior to Rodeo

(Current Grade and Conduct Requirements)                                                                   All Fees:

                                                                                                                                                Due with Entry

 

_____________________________________(date)_____________                                  Send Entry To:

  Terri Grinager

(School Administration Signature)                                                                                                    return_links(); ?>  16910 CO RD 3 NE

                                                                                                                                                                   Miltona, MN 56354

                                                                                                                                                Questions: (218) 943-1780 Evenings