Form

Florida Outlaws Mounted Shooting Club

"Headed for the Last Round Up" State Championship November 19th & 20th @10 AM Canterbury Showplace
Full Name*
First Name Last Name
E-mail*

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
Alias
Birth Date
Month Day Year
SASS Number*
Horse Name
Horse Breed
Horse Age
Match Fee 6 Stages*

Members $100.00 Non-Members $105.00 Buckaroo $10.00
Pick Your Division*
Pick Your Level*
Pick Your Poison

Rifle $30.00 Xtreme Stage $10.00
Exhibition Ride

Exhibition Ride $30.00
Exhibition rider must have a horse entered in the main match, to ride an exhibition horse. 3 stages only.
Stalls $36.00
Stalls are $36.00 for the weekend. If you come in Friday night there is N/C, you pay for Saturday and Sunday. Ground fee is $10.00 per day. Please do not put your horse in a stall unless you have reserved and paid for it. Thank You
All over night camping must have stall. No portiable pens are allowed. Don't put your horse in a paddock unless you have reserved it. Thank You
Shavings per bag $8.00
You can bring your own shaving or purchase shaving from Canterbury for $8.00
Camping Options

Primitive N/C Day fee per Horse $10.00
RV Site $27.32 Per Day/Night
(OPTIONAL) Tip for Balloon Setters please enter amount for tip
If you have entered the Main match your dinner ticket is included . For extra dinner for family and friends please enter the number needed. Thank You
Dinner Tickets for family & friends
Payment

Cash Check
To enter the match you must be SASS, CMSA, MSA or have come to a Florida Outlaw practice to varify you know safe gun handling skills.
Liability Release: As a participant and/or the parent or guardian of the individual named above, I understand that in signing below, I assume all risks and hazards incidental to particiaption in all activities associated with the Florida Outlaws Mounted Shooting Club, and do hereby waive, release, absolve, indemnify and agree to hold harmless the Florida Outlaws Mounted Shooting Club, its members and /or representatives, arena/land owners and sponsors for any claim arising out of injury, including death as a result of participation in FLORIDA OUTLAW MOUNTED SHOOTING CLUB activities. Checking the box and clicking the "Submit" button acknowledges your signature & acceptance of this agreement.

NO ALCOHOL ALLOWED

Before or During Match
I accept this release*

Acknowledgment
Should be Empty:

Florida Outlaws Mounted Shooting Club