Jackpot Registration Form

Jackpot Registration Form

Poles June 20, 2025
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
Please fill out 1 Form per Horse and Rider Entry
Which Division Are you Entering *
Rider Name *
Horse Name
Please Etransfer Payment to : standardrodeosociety@gmail.com

*Horse Name & Rider - Jackpot must be indicated in the notes section of Etransfer

Leadline = FREE

PeeWees = $15 per entry

Open = $30 per entry
Should be Empty: