RMBRA Jackpot Entry Form

GOLDEN SPIKE POWER SPORTS
August 10th
Tremonton Arena

The RMBRA will be naming individual RMBRA races after our Saddle Sponsors this year in appreciation for their support. We will also be supporting all of our other sponsors at our Summer Arena Brawl-Fall Arena Brawl & Winter Arena Brawl. We appreciate the support of all our great Sponsors!!

Entries & Time Only's: We accept: PayPal, credit/debit cards (added 4%fee)
Paypal.me/Rockymtnbarrels, Venmo -@Debbie-Conley-7

Time only draw will be ran in time blocks,(25 time onlys per block)

Time onlys will go to the RMBRA members first, then non members will fill in the time slots that are left.
No guarantee on the time slot you request.

Remember RMBRA members have first chance at time onlys .
To be in the draw, you must enter by 8:00 pm on Tuesday, August 9th
Pre draw will be posted at 10 pm. (approximately)

SCHEDULE
4:00-6:00 pm Time Only's (Pre-entry required) Time starting may vary.
6:30 pm Jr Youth Jackpot followed by-
15/50 non-carryovers
Open Barrels

RIDER: *

First Name Last Name

ADDRESS: *

Street Address City

State Zip Code

PHONE NUMBER: *

Area Code-Phone Number

BIRTH DATE *

Month Day Year

TIME ONLYS- $5 each- 25 per time block-please type approx time you would like (no guarantee on time- RMBRA Members get first pick)

HORSE #1 REGISTERED NAME:

HORSE #1 ENTRY

Open 5D Barrels $35 15/50 (Carry over from Open) $30 15/50 Run $30 16/49 (Carry over from Open only) $30 Rookie Horse (Carry over from Open, 15/50 or Jr Youth ) $25 Jr Youth Run $30 Jr Youth (carry over from 15/50) $30 Jr Youth (carry over from Open) $30

ENTRY FEES FOR HORSE #1:

HORSE #2 REGISTERED NAME:

HORSE #2 ENTRY

Open 5D Barrels $35 15/50 (Carry over from Open) $30 15/50 Run $30 16/49 (Carry over from Open only) $30 Rookie Horse (Carry over from Open, 15/50 or Jr Youth ) $25 Jr Youth Run $30 Jr Youth (carry over from 15/50) $30 Jr Youth (carry over from Open) $30

ENTRY FEES FOR HORSE #2:

HORSE #3 REGISTERED NAME:

HORSE #3 ENTRY

Open 5D Barrels $35 15/50 (Carry over from Open) $30 15/50 Run $30 16/49 (Carry over from Open only) $30 Rookie Horse (Carry over from Open, 15/50 or Jr Youth ) $25 Jr Youth Run $30 Jr Youth (carry over from 15/50) $30 Jr Youth (carry over from Open) $30

ENTRY FEES FOR HORSE #3:

HORSE #4 REGISTERED NAME:

HORSE #4 ENTRY

Open 5D Barrels $35 15/50 (Carry over from Open) $30 15/50 Run $30 16/49 (Carry over from Open only) $30 Rookie Horse (Carry over from Open, 15/50 or Jr Youth ) $25 Jr Youth Run $30 Jr Youth (carry over from 15/50) $30 Jr Youth (carry over from Open) $30

ENTRY FEES FOR HORSE #4:

TOTAL FEES OWED: PLEASE ADD $1 TO YOUR TOTAL FOR INSURANCE Entries & Time Only's: We accept: PayPal, credit/debit cards (added 4% fee) Paypal.me/Rockymtnbarrels, Venmo -@Debbie-Conley-7

COMMENTS: example- which horse to run first & etc

ROCKY MOUNTAIN BARREL RACING ASSOCIATION WAIVER: By signing this document, I agree that I am aware of and will abide by the Rules and Regulations of the Rocky Mountain Barrel Racing Association, Dash for Dollars and The Fall & Winter Arena Brawl. In addition, I hereby waive any/all claims which may arise between myself and the Rocky Mountain Barrel Racing Association (RMBRA)or between myself and third parties (i.e. Davis County, Weber County, Box Elder County, the Board Of Directors and the agents, members, servants, and employees) as a direct or indirect result of my participation in any RMBRA event. Should anyone or any legal entity bring such a claim, I agree to indemnify the RMBRA. My waiver does not include any claim I may have against the RMBRA for monies won as a result of my competitive performance at a RMBRA event. By signing this document, I agree that I have been informed of the Utah Equine Activities Law (U.C.A. §§78B-4-201 et seq.) and that there are certain risks inherent to my participation in an equine or livestock activity. I acknowledged that those inherent risk include dangers or conditions which are an integral part of equine or livestock activities, and may include the following: (a)The propensity of the animal to behave in ways that may result in injury, harm, or death to persons on or around them; (b)The unpredictability of the animal’s reaction to outside stimulation such as sounds, sudden movement, and unfamiliar objects; or (c) collisions with other animals or objects; or (d)the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the animal or not acting within his or her ability. Furthermore, I acknowledge that I am a “Participant” in an equine or livestock activity as define by Utah Code Ann. §§78b-4-201 and that my status as a participant will continue through the duration of the entire event (i.e. even subsequent to my competitive turn).

RMBRA JACKPOT Entry Form & Waiver