WCBRA Entry Form

WCBRA - Entry Form & Waivers
JACKPOT DATE*
MonthDayYear
Date
Rider*
First NameLast Name
Rider Date of Birth*
MonthDayYear
Date
Email
example@example.com
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Phone Number*
Area CodePhone Number
Order of Events:
Open Goat Tie, Goat Tail Pull, Kids Barrels, Kids Poles, Open Poles & Open Barrels.
Time Onlys follow each event.
Comments: example, separate my children or which horse to run first
Horse 1 Name
Horse 1 Entries
Arena Fee *REQUIRED* - $5Open Goat Tie - $6Open Poles - $10Open Barrels - $20Goat Tail Pull - $510 & Under Poles - $510 & Under Barrels - $5
Horse 1 Total
Horse 2 Name
Horse 2 Entries
Arena Fee *REQUIRED* - $5Open Poles - $10Open Barrels - $20Goat Tail Pull - $510 & Under Poles - $510 & Under Barrels - $5
Horse 2 Total
Horse 3 Name
Horse 3 Entries
Arena Fee *REQUIRED* - $5Open Poles - $10Open Barrels - $20Goat Tail Pull - $510 & Under Poles - $510 & Under Barrels - $5
Horse 3 Total
Goat Tie Time Onlys $4 each
Goat Tie Time Only Total
10 & Under Time Onlys $3 each
10 & Under Time Only Total
How many time onlys in each 10 & Under event?
Enter details here.
Open Pole Time Onlys $3 each
Open Pole Time Only Total
Open Barrel Time Onlys $3 each
Open Barrel Time Only Total
Signature of Participant or Legal Guardian
Clear
Total owed
Payments must be submitted by venmo @wcbra.
Entry is complete when your payment is received.
Should be Empty:

WCBRA - Entry Form & Waivers