California High School Rodeo Association - DOC by s2939Sm

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									           California High School Rodeo Association - District 2

DATE: Jan. 16-18th , 2009 Location: Lakeport, CA. (Lake County Fairgrounds)
Entries Close: Jan. 7th, 2009 MUST BE POSTMARKED BY CLOSING DATE!
CONTESTANT NAME:___________________________________________________________
Cutting CHECK IN: 6:30 pm Friday                                             Mail Entries to:
Cutting: 7:00 pm – Friday Afternoon                                          Stephanie Wheeler
                                                                             P.O. Box 847
CHECK IN: 7:00 to 8:00 am Saturday                                           Laytonville, CA 95454
Rodeo: 9:00 am Saturday 9:30 am Sunday                                       707-272-3283
                                                                 Make checks payable to: CHSRA Dist.2
MANDATORY MEETING: 8:00am Sunday

Please place a check mark next to the event you wish to enter and also a check mark next to Jackpot (if you
wish to enter for that event!)
                               Jackpot                                            Jackpot
____ Bull Riding ($72)          ______($10)              ____Pole Bending ($22)          ______($10)
____ Bareback ($72)             ______($10)              ____Barrel Racing ($22)         ______($10)
____ Saddle Bronc ($72)         ______($10)              ____Breakaway ($42)             ______($10)
____ Tie Down Roping ($42)      ______($10)              ____Goat Tying ($22)            ______($10)
____ Steer Wrestling ($42)      ______($10)              ____Girls Cutting ($42)         ______($10)
____ Boys Cutting ($42)         ______($10)
____ Team Roping ($42)          ______($10)                                 Total Event Fees _________
      Partners Name_______________________________                        Total Jackpot Fees _________
*For points purposes PLEASE indicate                                               Stall Fees_________
                                                                         Office/Ambulance Fee - $20.00
if you are a Header or Heeler (circle one)                                      TOTAL FEES ________

             A $5.00 fee for incomplete or incorrect entries will be charged!
“We the parents or guardians of                           ____ (name of contestant) give the Sutter Lakeside Hospital
and physicians on the medical staff of the Hospital, permission to administer Necessary Emergency treatment for
injuries he/she may incur while participating in the CHSRA District #2 Rodeo. We understand that each contestant
must be and is covered by medical insurance. We hereby release the Sutter Lakeside Hospital, its physicians on the
Medical staff and the Rodeo Sponsors from all Liability.”
                               SIGNED:
                                              (Parent or Guardian Must Sign, regardless of age of contestant)

 Contestant Signature                  _____            Membership #                 District #_____
Address                                                  City                      ____ Zip              _____
Telephone                                         _____ Grade                       Age

Name of High School
For School Official Validation:
“I do certify that this student meets both NHSRA Grade and Conduct qualifications (Must have passing
grades in minimum of 4 classes, if carrying less than 4 classes, must have passing grades in all) AND
CHSRA Requirements, which are: student has at least a 2.0 GPA as of the latest “GRADING PERIOD”
(Grading Period must cover 6 weeks or more) (Grading Period: Quarter, Semester, or “Progress Reports” mailed home
that are generated 6 weeks or more with ALL current grades and mailed to ALL students) (No “walk around” grades
accepted!)
Student must be in good standing; not ruled undesirable for misconduct at school.
SIGNED:                                                                 PHONE #

            Principal or Counselor (Place School Stamp or Seal over Signature)
  THE RELEASE BELOW MUST BE COMPLETED AND RETURNED WITH ENTRY
  FORM

    We the undersigned hereby release the Lake County Fairgrounds, City of Lakeport, West Coast Rodeo
    company; its officers and employees; all members of CHSRA, and any and all persons associated with the
    above said Rodeo from all liabilities, losses or damages to rider or property. We hereby give permission for
    the designated first aide person; Hospital and Physicians of the medical staff of the Hospital to administer
    necessary emergency treatment for injuries he or she may incur while at the above said Rodeo.

           Signature of Parent or Legal Guardian________________________________
      Date_____________________________

           Signature of Contestant_____________________________________________
      Date_____________________________


      List NEW sponsors since last rodeo:
      __________________________________________________________________________
      __________________________________________________________________________
      ___________________________________________

                           *NO LATE ENTRIES WILL BE ACCEPTED
               (all entries will be returned unopened if postmarked after due date)
                                *Membership cards required at check-in
                      *Contestants must be C.H.S.R.A. member in good standing
         *Set-ups: Form at the bottom of this sheet. All set-up forms must accompany rodeo
                            entry. Form must be completed in its entirety.

  SET-UP FORM (Only fill out if you need a set-up for this rodeo)
    Reason for Rodeo Set-up: ________________________________________________________________

    Date of School Function: ________________________________________________________________

    School Contact and Phone No.: _____________________________________________________________

      Signature of: School Athletic Director (for High School Team Sports Function)
        OR Principal or Counselor (if test or other School Related Function)
     MUST place School Seal or Stamp Over Signature
                                       Signature: ________________________________________________
                                                   (Signature of Principal or Relevant School Official)
   *Contact name at school must be completed. (He/She will be contacted by the rodeo secretary to verify
function and date.)
   *Set-ups are for high school functions only. Contestant must be a valid member of a school team, contest or
test activity occurring on the date of this rodeo.
   *Set-ups are for Saturday (or 1st go): meaning both goes run on Sunday or 2nd go.
   *Sunday set-ups will be accepted only if there are no contestants needing a Saturday set-up.
   *Set-ups will be run prior to the start of the 2nd go round. Stock and positions will be drawn for set-ups just the
same as other contestants.

								
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