TEXAS HIGH SCHOOL RODEO ASSOCIATION

TEXAS<= span style=3D'font-size:11.0pt'> HIGH SCHOOL RODEO ASSOCIATION

OFFICIAL ENTRY BLANK – QUALIFYING REGION V= II RODEO

Mail to: Anne Dollery = &nb= sp; Place: &= nbsp; Wharton Co. Fairgrounds in Crescent

P.O. Box 886 = &nb= sp; Date: &= nbsp;

Caldwell, Texas 77836 Time: 9: 00 a.m.

(979) 272-2249 (home) = Postmark Date: <= /o:p>

(979) 412-2551 (cell) &= nbsp; IN HAND: <= /o:p>

adollery@aol.com

NAME: ____________________________________________________________________= __

ADDRESS:_____________= _________________________CITY/ZIP:_____________________

PHONE #:_______________________________________GRADE:______________________<= /o:p>

CIRCLE THE EVENTS YOU WISH TO ENTER

EVENTS FOR GIRLS=             &nb= sp; ENTRY FEE      &nbs= p;             = PARENT’S SIGNATURE

1. Barrel Racing            =            $30                =        _______________________________= _

2. Pole Bending            =            $30        &= nbsp;           &nbs= p; ________________________________

3. Breakaway Roping            =              $30        &= nbsp;            &= nbsp; ________________________________

4. Goat Tying            =             &nb= sp;           $30<= span style=3D'mso-tab-count:2'>        &= nbsp;            &= nbsp; ________________________________

5. Girl’s Cutting        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;      ________________________________

EVENTS FOR BOYS&= nbsp;           &nbs= p;

1. Bareback Riding            =             &nb= sp;   $50        &= nbsp;            &= nbsp; ________________________________

2. Saddle Bronc Riding        &= nbsp;   $50        &n= bsp;            = ; ________________________________

3. Bull Riding            =             &nb= sp;           $50<= span style=3D'mso-tab-count:2'>        &= nbsp;            &= nbsp; ________________________________

4. Calf Roping            =             &nb= sp; $30        &= nbsp;           &nbs= p; ________________________________

5. Steer Wrestling            =         $30        &= nbsp;           &nbs= p; ________________________________

6. Boy’s Cutting        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;     ________________________________

EVENTS FOR BOYS= & GIRLS

1. Dally Team Roping            =             $= 30        &= nbsp;            &= nbsp; ________________________________

          Header:___= ___________________________ Heeler:_____________________________

(YOU MAY NOT ENTER OPEN**YOU MUST = HAVE A PARTENER**NO COURTESIES)

TOTAL ENTRY FEES DUE<= span style=3D'mso-tab-count:1'> $___________________Entries must be postmarked by the

OFFICE CHARGE        &= nbsp;    $_____23.00_________deadline, however they will be accepted

STATE OFFICE CHARGE   $______2.00_________if= in my hands by the late deadline with

LATE FEE ($25.00)        &= nbsp;          $_______= ___________a $25.00 late fee per rodeo

TOTA= L FEES        &= nbsp;         $__________________**Medical draw outs will be h= onored

        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;        ONLY if I am Notified BEFORE the

  &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp; Rodeo starts.

I certify that this student meets the National H= igh School Rodeo Association’s GRADE & CONTACT

Qualifications.= Minimum requirements: Student must have passing in 4 subjects or if carrying less than 4, =

Student must have passing grades in all subjects= :

SIGN= ED:______________________________________DATE:_____________________________= ___

        =        (COUNSELOR, PRINCIPAL, SUPERINTENDENT)

We, the Parents or Guardians of ______________________________(contestant) give permission to the

Physicians on the Medical Staff or the Hospital = to administer necessary emergency treatment for injuries
=
He/she may incur while participating in the offi= cially approved High School Rodeos. = We understand that Each contestant must be and covered by medical insurance. We hereby release the Hospital, Physicians on

The Medical Staff, and the Rodeo Sponsors from a= ll liability:

SIGN= ED:_______________________________________________________

        =           (PARENT OR GUARDIAN)