RACE FOR RESILIENCE Barrel Race Registration Form
Besler's Cadillac Ranch ~ May 18 2025
Registration Information
Please fill out information for registration. $50 Open per horse/$40 Youth per horse. $10 office fee per rider. Payment accepted day of event cash/check. All proceeds benefit the Artemis House Shelter.
Category
*
Youth (18 and under)
Open
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pro Elite #
WPRA ID #
Horse 1 Registered Name
*
Horse 2 Registered Name
Horse 3 Registered Name
Horse 4 Registered Name
Do you plan to complete exhibition runs? ($5 or 3 for $10)
*
Yes
No
Cost (Payment accepted day of event cash/check written to Jeanie Berns)
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Open Horse
Enter description
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Youth Horse
$
40.00
Quantity
1
2
3
4
5
6
7
8
9
10
Office Fee
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Exhibition Runs
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
Exhibition Runs -3
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Waiver- Participants – Assumption of Risk, Waiver of Liability, Indemnification and Release Agreement:
By submitting your entry, you are agreeing to "release" the listed entities from any legal responsibility for potential harm and you acknowledge the inherent risks associated with barrel racing, including potential injuries from falls, horse-related accidents, and other hazards. I agree to release Victims of Violence Intervention Program/Artemis House and Besler's Cadillac Ranch, all members, event organizers, employees, officials, arena and land owners, and any and all persons connected to Race for Resilience Barrel Race from losses, damages, injury to me, my equipment, property, and/or animals resulting from participating in and attending this event. This waiver implies that you understand and accept the inherent risks involved in barrel racing and attending such events. WARNING: UNDER SOUTH DAKOTA LAW, AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES, PURSUANT TO SDCL 42-11-2. Under 18, waiver must be signed by parent.
First Name
Last Name
Date
Waiver Signature
Please verify that you are human
*
Submit
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