NCPRA Membership Form

MEMBERSHIP APPLICATION

PLEASE FILL OUT FORM TO PROCEED TO PAYMENT
Name*

First NameLast Name
Membership Card Number (if returning member)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Social Security Number*
In the event of an emergency please contact: First Name* Last Name* Area Code* Phone Number*
Jacket Size*

SMLXL2XL3XLOther
Membership Type*

BarebackSaddle BroncBull RidingTie Down RopingSteer WrestlingTeam Roping (Header)Team Roping (Heeler)Barrel RacingBreakaway RopingRanch BroncStock ContractorSecretaryTimerPickup ManAnnouncerContract ActBull FighterJudgePhotographer
I, undersigned, hereby agree to be bound by and conduct myself in accordance with the rules established by the NCPRA. I agree that I will enter all contest at my own risk, that I will make no claims to the NCPRA or to any affiliated individuals or organization for injuries, loss, destruction, or theft to me or any of the property in my care. I am aware of the risk involved and know that injury may occur from participating in the sport of rodeo, for valuable consideration; the receipt of which I hereby acknowledged by all parties, I do hereby and forever discharge all members, producers, stock contactors, sponsors, land owners, committees and lessees of premises from any and all claims, demands, suits, actions, or cause of action which I may, can or shall have reason for any participation in the National Cowboy Pro Rodeo Association, LLC.
Signature*

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Date*

MonthDayYear
Date
High School Card/Minor (if yes, please have minor release singed and notorized)*

YesNo
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MEMBERSHIP APPLICATION