I, _________________________________________(Print name), have read the rules, and understand that this competition has the potential of being dangerous to either myself or my horse. I agree that I am riding at my own risk, and can not hold the J Bar D Ranch Inc, or any of it's associates or employees responsible for any injury, harm, or death that may occur to myself or my horse.
_________________________________________________(Sign name)
______________________________________________________(Signature of parent or legal guardian, if under 18yrs old)
________________________________________________(Date)
Phone number ________________________________________________________________________
City and state ________________________________________________________________________
(If you are only practicing, you do not need to fill out the horse info.)
Registered name of horse (if registered) ________________________________________________________________________
Horse's nickname ________________________________________________________________________
Horse's breed/s ___________________________________________________________________________
Mare, gelding or stallion? ___________________________________________________________________
What else is this horse used for or shown in? ____________________________________________________________________
Practice is $10 per horse. How many horses do you wish to practice? __________________
Print this form, fill it out, and send it, and a check (made out to The J Bar D Ranch) to:
J - D Ranch /Jacki Wilkins, 1124 R St, Geneva, NE 68361