FOUR STATES HIGH SCHOOL RODEO ASSOCIATION
2010-2011
2010-2011
CONTESTANT:________________________________
_____YES, I would like to be on the Automatic Call-In List
_____YES, I would like to be on the Automatic Call-In List
SR Boys
____Tie Down Roping $30.00
____Ribbon Roping $30.00
____Breakaway Roping $30.00
____Chute Doggin’ $30.00
____Bull Riding $45.00
____Bareback Riding $45.00
____Saddle Bronc Riding $45.00
____Tie Down Roping $30.00
____Ribbon Roping $30.00
____Breakaway Roping $30.00
____Chute Doggin’ $30.00
____Bull Riding $45.00
____Bareback Riding $45.00
____Saddle Bronc Riding $45.00
SR Girls
____Barrel Racing $30.00
____Pole Bending $30.00
____Breakaway Roping $30.00
____Goat Tying $30.00
____Ribbon Roping $30.00
____Barrel Racing $30.00
____Pole Bending $30.00
____Breakaway Roping $30.00
____Goat Tying $30.00
____Ribbon Roping $30.00
Team Roping (Boys & Girls)
______Header $30.00 _____Header $30.00
______Heeler $30.00 _____Heeler $30.00
Partner______________________ Partner______________________
______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
_____Steer Riding $45.00
_____Breakaway Roping (boys) $30.00
_____Breakaway Roping (Girls) $30.00
Team Roping (Boys & Girls)
_____Header $30.00 ______Header $30.00
_____Healer $30.00 ______Heeler $30.00
Partner____________________ Partner_______________________
_____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
_____Steer Riding $45.00
_____Breakaway Roping (boys) $30.00
_____Breakaway Roping (Girls) $30.00
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
_____Barrel Racing $22.00
_____Pole Bending $22.00
_____Goat Tying $22.00
_____Breakaway Roping $22.00
Entry Fees $______
Office Chg $20.00
Total Due $______
Office Chg $20.00
Total Due $______
Entry Form
MEMBERSHIP DUES $80.00
CHECK AGE GROUP: 10&UNDER (Maximum age 10 as of 8/1/10)____
JR -8th Grade & Under (Maximum age 14 as of 8/1/10)___
SR – 9th -12th Grade (Maximum age 19 as of 8/1/10)____
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 2010-2011 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 _________, 2010.
Notary Public_______________________in and for _______________________
County/Parish for the State of _______________________.
Complete, Notarize and return to:
CHECK AGE GROUP: 10&UNDER (Maximum age 10 as of 8/1/10)____
JR -8th Grade & Under (Maximum age 14 as of 8/1/10)___
SR – 9th -12th Grade (Maximum age 19 as of 8/1/10)____
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 2010-2011 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 _________, 2010.
Notary Public_______________________in and for _______________________
County/Parish for the State of _______________________.
Complete, Notarize and return to:
FOUR STATES HIGH SCHOOL RODEO ASSOCIATION
2010-2011
2010-2011
Membrship Application & Medical Release
| Jennifer Allen 475 CR 4358 Winnsboro, TX 75494 |
| Call In: 903-261-4932 Monday 6-9pm |
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.
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.
Order of Events
Pole Bending (Sr, Jr, 10 & U)
Barrel Racing (Sr, Jr, 10 & U)
Chute Doggin'
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)
Bareback
Saddle Bronc
Bull Riding
Pole Bending (Sr, Jr, 10 & U)
Barrel Racing (Sr, Jr, 10 & U)
Chute Doggin'
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)
Bareback
Saddle Bronc
Bull Riding
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.
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.
Dear Four States Member,
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 5, Rodeo, Purley, TX [Duke
Arena] 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,
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
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 5, Rodeo, Purley, TX [Duke
Arena] 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,
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
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