Pac West Barrel Racing - World Athlete Entrepreneur February 10

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Rider's Name

First Name

Last Name

2

Emailrequired please

example@example.com

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Mailing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

4

Phone Number

Area Code

Phone Number

5

Horse's Name

6

Days entered?

Friday

Sunday

Saturday

7

Horse's Name

8

Days entered?

Friday

Sunday

Saturday

9

Horse's Name

10

Days entered?

Friday

Sunday

Saturday

11

World Athlete Entrepreneur Sidepot SeriesRun for the 2023 finals - Do not have to be a member to run the class but, if you want to earn points you must be a member.

Member

NonMember

I would like to be a member

12

Payment I will total your entry fees and let you know how much is owed and how to send depending on how you want to pay. Please choose how you would like to send entry fees.

Paypal

Venmo

Cash App

FB Messenger Pay

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In accepting this entry, the applicant hereby releases and discharges the Florida Equine Athlete, all officers, personnel, representatives, employees, agents, Melissa Greer Ph.D., host arenas, arena owners, and family members from liability, loss, claims, damages, and/or expenses for injuries or death to person, animal, property, family member(s), friends, or anyone affiliated with applicant, reputations, or financial conditions as a results of, or in any way, relating to applicant’s participation or nonparticipation in any World Athlete Entrepreneur or Melissa Greer or Florida Equine Athlete sanctioned event whether caused by negligence, arena conditions, and/or by the conduct of the Florida Equine Athlete, cosanctioned hosts, or arena hosts, owners, officers, etc.PLEASE BE SURE TO MARK THE BOX BELOW.

I have read, understood, and accepted the above waiver statement for entry and participataion of this show.

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Signature For Youth entries, this form MUST be signed by parent or guardian; I will need a parent or guardian to verify this permission at the day of the show.

Clear

15

Date signed

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I will send you an email confirming your entry and let you know the total entry fee, with the information to the payment method you want to pay through.