Jane Melby Barrel Racing Clinic

PRINT/MAIL REGISTRATION FORM

NFR Qualfier
(winning 3 rounds!)
World Champion:
IPRA& NBHA
Jane Melby
Barrel Racing Clinic

October 26-28, 2012
JJ Arena
Balsam Lake, WI

Clinic Attendee Information: Please print and bring with to clinic.
Name:	Age as of 1/1/12
Address:	E-mail:
City,State Zip::	Returning student	Rider x _____ Audit x ____
Phone:	Location of previous clinic(s)

Notes about you and your horse...How long have you been riding? What events do you typically compete at? How old is your horse? What do you expect to get out of this clinic?

Disclaimer of Liability I hereby request to participate in the Jane Melby Clinic. I agree to release and hold harmless Jane Melby, arena owners, event promoters, sponsors, and any person connected with this event and endorsed events from losses, damages, or injury to me, my equipment, and/or my animals resulting in my attendance or participation in any Tuff Enuf Ranch produced or endorsed event. Jane Melby, JJ Arena a and event producers assumes no liability to those who have not read these conditions and having not read these conditions, they are still held to their contents.

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Signature & Date

Pay via credit card or PayPal with a 3% fee or print and mail registration form along with a check or money order to:
Jessica Beauvais; 960 Bunyan Ave; Balsam Lake, WI 54810.
Spots are not reserved until payment is received. Deposits are non-refundable.

We look forward to seeing you there!

Jessica Beauvais & Jane Melby
Jessica@ubra.org 715-857-6343