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FOUR STATES HIGH SCHOOL RODEO ASSOCIATION
2009-20010
CONTESTANT:________________________________
_____YES, I would like to be on the Automatic Call-In List
SR Boys SR Girls
____Tie Down Calf Roping $30.00 ____Barrel Racing $30.00
____Ribbon Roping $30.00 ____Pole Bending $30.00
____Chute Doggin’ $30.00 ____Goat Tying $30.00
____Bull Riding $42.00 ____Breakaway Roping $30.00
____Bareback Riding $62.00 ____Ribbon Roping $30.00
____Saddle Bronc Riding $62.00
____Breakaway Roping $30.00
________Team Roping (Boys & Girls)
______Header $30.00 _____Header $30.00
______Heeler $30.00 _____Heeler $30.00
Partner______________________ Partner______________________
JR Boys & Girls
_____Barrel Racing $30.00 ______Chute Doggin’ $30.00
_____Pole Bending $30.00 ______Tie Down Roping $30.00
_____Goat Tying $30.00 ______Ribbon Roping $30.00
_____Breakaway Roping $30.00 ______Jr Steer Riding $42.00
_________Team Roping (Boys & Girls)
_____Header $30.00 ______Header $30.00
_____Healer $30.00 ______Heeler $30.00
Partner____________________ Partner_______________________
10 & UNDER Boys & Girls
_____Barrel Racing $22.00
_____Pole Bending $22.00
_____Goat Tying $22.00
_____Breakaway Roping $22.00
Entry Fees _________
Office Chg _20.00_
Total Due ______
MEMBERSHIP APPLICATION/MEDICAL RELEASE
2009/20010
MEMBERSHIP DUES $80.00
CHECK AGE GROUP: 10&UNDER (Maximum age 10 as of 8/1/09)____
JR -8th Grade & Under (Maximum age 14 as of 8/1/09___
SR – 9th -12th Grade (Maximum age 19 as of 8/1/09)____
NAME______________________________________________________
ADDRESS___________________________________________________
CITY___________________________STATE______________ZIP___________
PHONE_________________________E-MAIL___________________________
DATE OF BIRTH__________________CELL PHONE _____________________
I, the undersigned, do hereby certify that_______________________is a student in
good standing and enrolled in the _____grade at _________________School.
Date________________________Principal/Superintendent_________________
MEDICAL RELEASE/ACKNOWLEDGEMENT
I hereby agree to release the Four States High School Rodeo Association, any
member or officer, any producer, club or organization or any individual member of
the Four States High School Rodeo Association from responsibility in case of any
accident or injury to my son/daughter ____________________during the 2008-09
Rodeo year and release all of the above from any theft, loss or damage that may
occur during a rodeo sanctioned by the 4SHSRA. I hereby grant and authorize
permission for my son/daughter to be transported to a hospital and given treatment
by any doctor, hospital or personnel of either and hereby release said doctor,
hospital and personnel for transporting contestant to hospital and administering
necessary treatment if any.
I further acknowledge that there is a NO TOLERANCE policy on alcohol and illegal
drugs use on rodeo grounds. Failure to comply with this policy may result in the
disqualification of contestant.
Contestant_____________________Parent/Legal Guardian________________
Sworn and subscribed to me in my presence this______day of _________, 2009.
Notary Public_______________________in and for _______________________
County/Parish for the State of _______________________.
Complete, Notarize and return to:
Membership
Senior contestants must be in grades 9-12 and less than 20 years of age and not yet
earned a high school diploma.
Junior contestants must be in the 8th grade or under & 14 years of age and under as of
August 1 of that rodeo season. A junior contestant may chose to become a Senior Member
and participate in Senior Events with the exception of rough stock. Once a senior member,
you cannot move back into the Junior division until the next rodeo year, and only then if you
are eligible for a Junior membership the next rodeo year.
10 and under contestants have the option to become a Junior member and participate in
the Jr. Events after two rodeos. Once you have declared to become a Jr member you may
NOT move back into the 10 & under until the next rodeo year, and that is only if you are
eligible to be a 10 & under member the next year.
Contestants must be in good standing in conduct and under accredited curriculum at school.
Events
Senior Boy Events Senior Girl Events
Tie-Down Calf Roping Cloverleaf Barrel Racing
Ribbon Roping Ribbon Roping
Bull Riding Break-Away Roping
Break-Away Roping Goat Tying
Chute Doggin' Pole Bending
Team Roping-- Boys & Girls
Junior Events 10 & Under Events
Tie-Down Calf Roping Cloverleaf Barrel Racing
Ribbon Roping Pole Bending
Cloverleaf Barrel Racing Break-Away Roping
Pole Bending Goat Tying
Chute Doggin'
Goat Tying
Break-Away Roping
Jr. Bull Riding
Team Roping
Order of Events
Pole Bending (Sr, Jr, 10 & U)
Barrel Racing (Sr, Jr, 10 & U)
Chute Doggin'
Bull Riding
Goat Tying (Sr, Jr, 10 & U)
Tie- Down Calf Roping (Sr, Jr)
Break-Away Roping (Sr, Jr, 10 & U)
Ribbon Roping (Sr Boys, Sr Girls, Jr)
Team Roping (Sr, Jr)
Dress Code
Contestant must were a western hat, western boots, a long-sleeved shirt with a collar and a
long western style pant. Sleeves must be rolled down and buttoned or snapped and shirttail
must be tucked in at all times. Dress code must be observed 30 minutes prior to the start of
the rodeo. Contestant DO NOT come into the arena unless you are in full dress code!
Exceptions to the dress code:
Rough stock rider and they may roll their sleeve to the elbow of their riding arm.
Contestants may wear protective headgear when competing.
Each member is being asked to sell $50.00 worth of advertisement for the finals
program. This is a mandatory fundraiser. In order to be eligible for the finals, your ad
money must be turned in to rodeo secretary by March 6, Rodeo, Cooper Texas.
Attached is a page that will help explain ad prices and sizes. Please fill out the following
information and staple it to any written requests, art work, business cards and or special
instructions. Please use the bottom of this page as a receipt for the person purchasing
the ad.
Thank you,
Stacy Taylor
and Kathy Johnson
4SHSRA Member:___________________________________
Circle size of ad sold: BC – 25.00; ¼- 35.00; ½- 50.00; Full –100.00
Amount Collected: $______________
Date:_________________
Received in payment the amount of $_____________ for a donation to the Four States
High School Rodeo Association for advertisement in their finals program.
Thank you,
_______________________________
Signature of Member