WCBRA Entry Form

WCBRA - Entry Form & Waivers
JACKPOT DATE
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Rider
First NameLast Name
Rider Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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
Horse 1 Total
Horse 2 Name
Horse 2 Entries
Horse 2 Total
Horse 3 Name
Horse 3 Entries
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