Name:
Birth Date:
MaleFemale
Telephone:
Cell phone:
Address:
City:
Postal Code:
Parents' Name (if under 18 years of age):
Email Address (For correspondence and entry confirmation):
Emergency Contact Name:
Emergency Contact Phone:
Membership Types
Fees
Senior Membership
$200.00
Junior Membership – 15 as of Jan 1st Age verification required ex. Birth cert, or health card
$100.00
Pee Wee Membership – 11 as of Jan 1st Age verification required ex. Birth cert or health card
$50.00
First time ROUGH STOCK member (SB, BB, BR only)
Pee Wee and Junior contestants wishing to compete in open events must purchase an open membership before entering an open event. Pee Wee and junior contestants may still compete within their age category. Pee Wee contestants must purchase a Junior membership to compete in junior events and then cannot enter same events in the Pee Wees.
SeniorJunior - 15 as of Jan 1stPee Wee - 11 as of Jan 1stNon-Competing
I give my permission to use my name and images for promotional and educational use for the KCRA. I waive any rights or claims compensations for pictures, photos, and recordings.
I hereby release the KCRA, its officers, and employees from any, or all claims of harm and liability as a result of photographs, videos, and images occurring during a KCRA event
I AGREE TO BECOME FAMILIAR WITH AND ABIDE BY ALL K.C.R.A. BY LAWS, RULES AND REGULATIONS DURING THE TIME I AM A MEMBER OF THE K.C.R.A.
I hereby warrant and represent that I am 18 years of age or older. It is herby agreed that if the Kakeyow Cowboys Rodeo Association grants the applicant a membership, the under signed will accept full responsibility, release and save harmless the Kakeyow Cowboys Rodeo Association, all producers and committees from all losses, injuries and damages the applicant may suffer and receive and also indemnify the Kakeyow Cowboys Rodeo Association and all producers and committees from all losses or damages that may incur which the applicant may cause to other persons or property while participating in any rodeo that is approved by the Kakeyow Cowboys Rodeo Association. If applicant is under the legal age the parent or guardian of said person must sign.
Signature of Applicant:
Signature of Parent or Legal Guardian: (If applicant is under 18 yrs of age)
Date:
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