UBRA Show Certification: Mailing Submission Form

Email flyer for your event to info@ubra.org. If you have any questions, contact the UBRA by phone at (715) 857-6343 or email.

UBRA Certification Benefits:
Online flyer linking from UBRA.org, Results posted online at UBRA.org & Event listing in monthly UBRA eNews

Insurance Available to those who need.
+ Insurance Request Form in Word
+ Insurance Request Form in PDF

List dates below. DATES: # DATES ____X $25 =_______TOTAL
The $25 UBRA certification includes certification for each UBRA division (PeeWee, Youth, Open, Senior Futurity & Derby).
Additional certified classes may be added for $5 per class.
List additional classes below.
  1. Jackpot Barrel Race:
    • Standard certification includes: PeeWee, Youth, Open, Senior, Futurity & Derby.
    • Producer may add any additional class for $5. UBRA members earns points in their respective UBRA membership division class (ie: youth member earns points in youth class, open member in open class).
  2. WSCA Horse Show/Fun Show/Play Day Event:
    • Standard certification includes: Pee Wee (rider 10 years and under), Junior Rider (11 to 13 years), Intermediate Rider (14 to 17 years), Senior Rider (18 to 34 years), Sr.+ Rider (35 to 49 years) and Sr.++ Rider (50 years and over)
    • The producer may certify their jackpot class for an additional $5.
    • Double judged classes will receive 1 set of points per class, not per judge
Class Name & Age Restriction
Added $$:
Event Times:
Event Name:
Business Name:
Phone:  Cell Phone:
City, State & Zip:
The UBRA logo is mandatory, please choose any of the following banners. To download a banner image to your system right click on the image and save it to your local system. Remember to include the
UBRA logo on your flyer.

Payments are also accepted via PayPal or online via credit card with a 5% fee. Form must be mailed.
PayPal payment; send to info@ubra.org. Pay via Credit card here.

The information provided above is complete and accurate to the best of my knowledge, and I hereby request
endorsement of the above listed show by the United Barrel Racing Association, LLC (UBRA, LLC). I have read and am familiar with the
UBRA rules and guidelines for endorsed shows and agree to abide by and be bound to them. I will submit a
complete copy of the show results and any UBRA membership applications and fees to the UBRA office within
seven (7) calendar days of the completion of each show. I understand that failure to comply with the above
mentioned rules and guidelines or to submit show information and fees can result in UBRA withdrawing
endorsement of any subsequent shows.
I agree that the United Barrel Racing Association, LLC , assumes no liability if I have not read these conditions and having not
read these conditions, I am still held to their contents. I further agree that if any dispute should arise
involvingthe United Barrel Racing Association, LLC , the proper venue shall be Polk County, in the State of Wisconsin.

Signature:___________________________________ Date:____________

Submit completed application and fees to:
UBRA, LLC; 960 Bunyan Ave. Balsam Lake, WI 54810

Referred by: ______________________________________