LA PINE

LA PINE
RODEO
July 19th Playday Buckle Series Form
TODAYS DATE

MonthDayYear
Date
First Name
Last Name
Phone Number
Horses Names
Emergency Contact
Phone
If Competitor is under the age of 18:
Competitor Age
ParentGuardian
Phone
AGE DIVISION

Pewee (6 & under)Junior (7-9)Intermediate (10-13)Senior (14-17)Adult (18-49)Super Senior (50 & up)
Events

Barrel ReacingPolesSpeed BarrelsKey Hole
Total
Volunteer Sign-Up (Please check one):

Gate - First 2 EventsGate - Last 2 EventsBarrels - Setup & Pattern ResetSpeed Barrels - Setup & ResetPoles - Setup & ResetKey Hole - Setup & Reset
I am signing this Entry Form freely and voluntarily on behalf of myself and/or my minor child(ren
Participant Name
Participant Signature

Clear
ParentGuardian Name
ParentGuardian Signature

Clear

My Products

Barrel Racing

$5.00 Quantity

Poles

$5.00 Quantity

Speed Barrels

$5.00 Quantity

Key Hole

$5.00 Quantity

Total

$0.00