winter blast official entry form
TRANSCRIPT
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8/14/2019 Winter Blast Official Entry Form
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Heart O Texas Fair and Rodeo & C.T.B.R.A. 1st Annual
WINTER BLAST Pre-Enter Without Pre-Paying!!February 19, 20, 21, 2010Heart O Texas Fair Complex Dodge Show Pavilion**PRE-ENTER BY FAX ONLY WITHOUT PRE- PAYING! YOU MUST CHECK IN
AND**PAY AT LEAST 1 HOUR BEFORE YOUR RUN, OR A TURN OUT WILL BEGIVEN!
**If you dont pay/ show on time & get a TO, you may run at the end with a$20add.fee
PRE-ENTRY DEADLINE FOR 5D OPEN & 3D POLES FRIDAY FEB. 12,2010
LATE FAX ENTRIES ACCEPTED THROUGH MONDAY FEB. 15, 2010MAY ENTER ON SITE, LATE FEES APPLY, ENTER UNTIL LAST 25 RUNNERS
PRE-ENTRY FAX NUMBER: 512/685-1115 Draw Posted Feb. 16*Cash or Checks Accepted for All Races. No Credit Cards Accepted.*Equal Pay Out All Races, 80% Pay Out 4D Warm Up, Open 5D, 4D Incentives &3DPoles.*Saturday 5D Open $50 Entry, 4D Incentives $20 Entry, Pre-enter to avoid late feeor Enter on Site (late fee applies).
*Friday Exhibitions $5 each, 4D Warm Up Race $30 Entry Fee,Enter on Arrival-nolate fee*Saturday 3D Pole Race $30 Entry Fee, Pre-Enter to avoid Late Fee or Enter Late onSite*Sunday C.T.B.R.A. Regular Point Show-Non Members Welcome, Pre-Entries takenor enter on arrival. See C.T.B.R.A. Entry Form or visit www.ctbra.ebarrelracing.com for rules.*Stalls $15/ night, RV-$20/ night, Shavings-$9/bag, No Outside Shavings Allowed.No Reservations, See Dodge Pavilion Office Upon Arrival-Cash/Checks/Credit Cardsto facility.Stall Office Opens Friday Feb.19, 9a.m.PROCESSING FEES: $10 each for 4D Warm Up, 5D Open, 3D Poles orExhibitions LATE FEES: $10 each for 5D Open and 3D PolesFor Questions Contact: Mitzi Angelle, [email protected]
, 512/422-4821
Current Coggins Required at Check In. Fair Ground Drag Draw will be used.
http://www.ctbra.ebarrelracing.com/mailto:[email protected]://www.ctbra.ebarrelracing.com/mailto:[email protected] -
8/14/2019 Winter Blast Official Entry Form
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*PLEASE PRINT
Rider Name:_______________________________________Address:___________________________________________
City:______________________State:______Zip:_________
Phone:_____________________________________________
Date of Birth:______________________________________ **Must be Provided, 18 & Under be prepared to show proof of age ifasked!
Soc.Sec#__________________________________________ **Must be provided or Entry will Not be Taken
Email:_____________________________________________IDENTIFICATION AND RELEASE OF PERSONAL INJURY
By signing this document and by making entry as a participant, I hereby understand that
injury/death to myself, my horse, or my child is a possibility no matter how careful the
sponsors, officers, directors or participants may be. And furthermore, I as a participant (or
parent/guardian), agree to hold harmless H.O.T. Fair and Rodeo and C.T.B.R.A. and their
officers, agents, management, contractors and employees from any expense, cause of action,
damage, or claim of damage (including legal fees) of any kind whatsoever which I might
assert as a result of m y (or my Childs) injury. I recognize t hat this is an Equine Sporting
Event and I ( or my child/charge) are riding at my or childs own risk.
Signature:___________________________________________
Parent/Guardian:_____________________________________
Date:________________________________________________
SATURDAY(Use extra entry form if more than 5 horses) SATURDAY
5D OPEN 10a.m.___ x $50=________ 3D POLES $500 ADDED! Youth Adult Senior4D Incentives ______x $20=________ (18 & Under) (19-39) (40+) 8p.m. _____x $30=________
_____________________________________________ _____________________________________________Horse Horse
_____________________________________________ _____________________________________________Horse Horse
_____________________________________________ _____________________________________________Horse Horse
_____________________________________________ _____________________________________________Horse Horse
_____________________________________________ _____________________________________________Horse Horse
(4D Incentives are Second Splits carried from Open)Total Entries 5D__________ Total Entries 3D Poles________Total Incentives _________ Late Fee________ Late Fee__________ For Office Only Process Fee 10.00_
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Process Fee 10.00 *If you Dont Pay/Show On Time & get a TO you may run at the end with $20 Add.Fee Total:________Total Fees:__________ Turn Out Fee $20 ___________