Media Credentials Request Form
Gold Buckle Futurities
Name of Media Representative
First Name
Last Name
Name of Media Organization
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Mailing Address
Street Address
City
Please Select
Alabama
Alaska
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California
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District of Columbia
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Maine
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Postal Code
Type of media coverage (please select all that apply):
Photography
Videography
Writer
I am on assignment for (please check all that apply):
Sponsor
Horse Owner
Horse Trainer
Publication
Instagram Handle
Media Facebook Page
Please provide the list of horses/riders that you plan to cover:
2024 Fall Roping Media Pass
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Media Crendentials Usage Fee
$
200.00
Quantity
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Credit Card
Your signature
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