ENTRY APPLICATION

                                                           TO

                                     OLD WEST BRONC RIDING

                                       WORLD CHAMPIONSHIP

                                                ELKO, NEVADA

                                           July 10, 11, &12, 2008

NAME______________________________________________________________

MAILING ADDRESS__________________________________________________

                                    __________________________________________________

PHONE                                              FAX (If available)                                               

 

Please list any previous events in which you have received prize money or prizes in the last two years.  We would like to have this information to provide to the announcer for your recognition during the competition.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Can we use your name in advertising this event?     YES      NO     

 Will you have sponsors and if so, please list so they may receive recognition. ______________________________________________________________________________________________________________________________________________________________                                                                                                                       

Would you like to be included in a calcutta to be held on Thursday, July 10?  YES   NO

 

a)         Entry fee is $325.00 with the first 40 entries being accepted.

b)         All entries must be accompanied by a $50 deposit and a signed Release which

is on the back of this entry.

c)         Total fees ($325) must be paid on or before June 15.

d)         Riders are encouraged to get sponsors for the entry fee. Sponsors will be announced during the ride.  The Silver State Stampede Association can provide riders a sponsor on a 40/60 split.  Rider must pay 40% of entry fee, sponsor 60%.  Any money won will be split the same way.  For more information, contact the Silver State Stampede Association at the address shown on the bottom of this entry.

e)         Entries will be accepted until June 15, 2008 or when full

f)          Any deposits or payments made after the first 40 entries are received and accepted will get a full refund.

g)         New entries postmarked after June 15, will cost $400 if accepted.

 

Would you want the Association to obtain a sponsor for you?   YES     NO

Deposit enclosed____________________

Return entry and Waiver to:

Silver State Stampede Association                                                    J.M. Capriola Co.

P.O. Box 5635                                         O R                                    500 Commercial Street

Elko, Nevada 89803                                                               Elko, Nevada 89801

            775.738-6342 leave message                                                            775.738-5816

SEE OTHER SIDE FOR WAIVER TO BE SIGNED

 

 

                                 RELEASE AND ASSUMPTION OF RISK

 

The undersigned has submitted an entry application to the Silver State Stampede Association to participate in the World Championship Saddle Bronc Riding.  The undersigned acknowledges that there are risks of injury in such an event, and if he is successful in his entry, application hereby assumes all responsibility and all risk for any injuries that may result from his participation in the event.

 

The undersigned hereby releases and forever discharges the Silver State Stampede Association, Inc., the directors, and agents of that corporation and the stock producer and any of his employees or agents from any responsibility or liability from any injuries that may occur from whatever source or nature while participating in the competition saddle-bronc riding. 

 

The undersigned further represents that the foregoing statement has been read and voluntarily and with full knowledge of its contents does hereby execute the same.  The undersigned further

acknowledges that this Release and Assumption may be used against him to prevent recovery or compensation of any type or nature against persons or entities which have been release herein.

 

Dated this _________day of ____________

 

___________________________________

Signature

 

___________________________________

Please print or type name

 

NOTE: If contestant is 18 or under, a parent must consent to this release by execution below before a Notary Public

 

I hereby certify that I am the parent of the above and by execution hereof consent to his entry into the event and the above Release and Assumption.

 

______________________________

 

State of _____________)

    )ss

County of ___________)

The foregoing was acknowledged before me on this _______

day of ____________, ______________ by _______________________

 

_____________________________________

NOTARY PUBLIC