INDIGENOUS RODEO & NON POINTS ENTRY FORM

Mount Isa Mines Rodeo Non Points Entry Form

ALL MINI BULLSs (Main Rodeo & Indigenous Rodeo), Station Buckjump, Senior Steer Ride
Mount Isa Mines Rodeo

Aug 7th - 9th
Participant Detials

Please fill out below details, read and sign waiver where required.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Post Code
Date

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Risk Warning and Waiver of Liability

Name & Address of Provider: Australian Professional Rodeo Association PO Box 264, Warwick, QLD 4370
The following pages affect your legal rights and obligations. Please read these carefully and only sign if you fully understand their contents. For Participants under 18 years of age, these documents must be completed by a parent or legal guardian.

Description of Activities: RODEO

Risk Warning
I am aware that by my participation in any activities arranged by the Provider, certain risks or dangers may occur which could include:
• Physical, bodily or psychological injury or death.
• Physical exertion to which I am not accustomed.
• Failure of equipment or use of inadequate equipment.
• There may be no or inadequate facilities for treatment or transport to treatment if I am injured.
• The conditions in which the activities are conducted may vary without warning.
• I may cause injury to other persons and/or other persons may cause injury to me.

1 Provider includes the officers, employees, agents, contractors, franchisees and assigns of the Provider.
2 Activities includes all activities and services ancillary to or associated with the named Activity, both before and after the Activity, including transportation to and from the location of the Activity whether provided by the Provider or not, briefings, inductions, training, and the provision of information in all manuals, safety guidelines and other documentation provided to or made available to the Participant with respect to the Activity, familiarisation with clothing or equipment and methods of operation of equipment and the wearing and removal of any clothing or equipment associated with the Activity. Unless otherwise specified, a reference to an Activity is a reference to a recreational service or a recreational activity as defined in relevant legislation referred to herein.
Declaration and Signature

I have read carefully and understand this risk warning and waiver of liability and sign it freely and voluntarily without inducement of any kind.
Signature of Participant
Date (Participant Signature)

MonthDayYear
Date
Signature of Witness
Name of Witness

First NameLast Name
Date of Witness

MonthDayYear
Date
For Participants under age 18

This is to certify that I, as a parent/guardian with legal responsibility for the Participant, acknowledge, understand and accept all of the above and consent to his/her release as provided above. I release and agree to indemnify and hold harmless the A.P. R.A. Inc from any and all liabilities arising from my minor child’s involvement or participation in the Activities and/or recreational services, even if arising from the negligence of the A.P.R.A. Inc.
Signature of Legal Guardian
Date (Legal Guardian)

MonthDayYear
Date
Name of Legal Guardian

First NameLast Name
Signature of Witness
Date (Witness for Legal Guardian)

MonthDayYear
Date
Bank Account Details

Please provide bank account details below for Prize Money Payouts
Account Name
BSB
Account Number
NON AFFILIATED Rodeo Entry Details

Please select events you wish to compete in for this rodeo. All prices shown are inclusive of GST and our payment processing costs, including square fees where applicable but you may still be charged a small processing fee.

My Products

MAIN RODEO Day Membership

Select Senior or Junior Membership from Drop Down

$44.00 AUD Day Member
Item subtotal:

Station Buckjump

Prize Money $2000, no add back. Capped at 15 entries. Saturday Night 8th August. Must be 17 years and over. NO JUNIORS.

$80.00 AUD

Bullock Ride

Prize Money $2000, no add back. Capped at 20 entries. Friday Night 7th August. Must be 17 years and over. NO JUNIORS.

$80.00 AUD

Mini Bull 8 - 10

Prize Money $500, no add back. Capped at 20 entries.

$44.00 AUD

Mini Bull 11 - 14

Prize Money $500, no add back. Capped at 20 entries.

$44.00 AUD

INDIGENOUS RODEO - Mini Bull 8-10

Prize Money $500. One round only. Capped at 20 entries.

$44.00 AUD

INDIGENOUS RODEO - Mini Bull 11-14

Prize Money $500. One round only. Capped at 20 entries.

$44.00 AUD

Total

Payment Methods

Credit Card

Apple Pay

Please note that Day Membership Fees and Entry Fees are not refundable.

Your entry is not valid until a confirmation email has been received from Mount Isa Rodeo Scretary. You will receive a confirmation email when your entry is processed, this may take up to 48 hours. Any issues with your non-affiliated event nominations please email Nominations@mtisarodeo.com.au
Should be Empty:

Mount Isa Mines Rodeo Non Points Entry Form

Mount Isa Mines Rodeo

Participant Detials

Risk Warning and Waiver of Liability

Declaration and Signature

For Participants under age 18

Bank Account Details

NON AFFILIATED Rodeo Entry Details

My Products

Payment Methods

Please note that Day Membership Fees and Entry Fees are not refundable.