PLEASE PRINT FORM OUT & MAIL WITH PAYMENT TO: UBRA; 960 Bunyan Ave, Balsam Lake, WI 54810 One Form Per Rider - OPEN TO ANYONE AND HORSES OF ANY AGE! PRE-ENTRIES Must be postmarked FRIDAY MAY 8TH. On site entries accepted.
Name:
Phone :
+Added Money & Awards for UBRA Members.
Non-members eligible for regular 80% payback & $100 Added MR4$. +Carry overs accepted for 2D Futurity and for 1st Open 4D on Monday from $100 Added Memorial Run for the $.
+WESTERN/UBRA ATTIRE REQUIRED: Long sleeve button down western shirt or UBRA logo clothing & heeled boots.
Address:
UBRA #
City
SSN #
State, Zip:
Email :
SATURDAY
Open 4D.
$30 Entry Fee UBRA: $250 ADDED Min. & Division Awards
1.
2.
3.
2D Futurity
$20 Entry Fee UBRA: Division Awards
1.
2.
PeeWee
$5 Entry Fee. No Payback. Awards
1.
2.
Youth 4D.
$20 Entry Fee UBRA: Division Awards
1.
2.
Open 4D.
$20 Entry FeeUBRA: Division Awards
1.
2.
3.
SUNDAY
Open 4D.
$30 Entry Fee
UBRA: $500 ADDED Min. & Division Awards
MONDAY: Memorial Run for the $
2D Half Sec. $100 Entry Fee $100 Added
1.
2.
UBRA Membership
$ __________
UBRA Optional Membership:
Include eligibility for $2000+ Cash & Awards
2009 UBRA Membership: Open $50/Youth $30/Futurity $30/Pee Wee $20.
Weekend only membership $25
Combo membership $50+$20 per adtl member/division. $100 max family membership
$10 per day/$30 weekend. No office fee for PeeWee only entries.
Electrical:
$ __________
CAMPING: Electrical hook-up $25 Per night. CAMPING ONLY: $10 per night
Stall /Tie Out Fee:
$ __________
Stallings $40 for the weekend. $5 refund for clean stalls.Bring your own shavings.
Overnight Tie Outs $2 per day, per horse.
Total Fees:
$ __________
Make Checks Payable to: UBRA ~ Send entries & checks to: UBRA; 960 Bunyan Ave, Balsam Lake, WI 54810
I hereby agree to make it my responsibility to know and abide by the rules at any and all UBRA Certified Shows. I understand that not knowing the rules IS NOT an acceptable excuse for disobeying the rules. I expressly waive and release any and all claims for personal injury or any other claim which I may have now or in the future against UBRA, its officers, directors, promoters, staff arising out or in connection with my affiliation with the association or my participation in UBRA certified events. Disclaimer of Liability. I agree to release and hold harmless The UBRA, arena owners, event promoters, sponsors, and any person connected with UBRA produced and endorsed events from losses, damages, or injury to me, my equipment, and/or my animals resulting in my attendance or participation in any UBRA produced or endorsed event. United Barrel Racing Association assumes no liability to those who have not read these conditions and having not read these conditions, they are still held to their contents. Notice: A person who is engaged for compensation in the rental of equines or equine equipment or tack or in the instruction of a person in the riding or driving of an equine or in being a passenger upon an equine is not liable for the injury or death of a person involved in equine activities resulting from the inherent risks of equine activities, as defined in section 895.481(l)(e) of the Wisconsin Statutes.
_______________________________________________ Date ____________
Signature (18 or under parent or legal guardian must sign) We're glad you're coming - drive carefully! Questions contact Jessica (715) 857-6343 or info@ubra.org