| ENTRY
FORM |
| Rider: |
|
| Address: |
|
| City/State/Zip: |
|
| Phone: |
|
| E-Mail: |
|
| Birthdate: |
|
| Soc
Sec #: |
|
| BBR
#: |
|
| Please
complete all fields above (including Soc Sec # and Birthdate)! |
Entries
List
registered name of each horse. Negative coggins
and health papers will be required for each horse at check-in)
Incentive Ages as of 5/10/07: Yth (15 & Under), Adult (16-49),
Sr (50 & over) |
| |
Horse
1:
~
Incentive 1: |
|
| |
Horse
2:
~
Incentive 2: |
|
| |
Horse
3:
~
Incentive 3: |
|
| |
Total: |
@
$120ea. =$
|
| Incentive
Fees: |
@
$30ea. =$
|
| Late
Fee: |
@
$25ea. =$
|
|
Horse
Stalls:
includes
2 shavings
|
@
$65ea. =$
|
| Tack
Stalls: |
@
$55ea. =$
|
Processing
Fee : |
@
$20ea . =$
|
| TOTAL
DUE : |
|
$
|
Amount
Enclosed:
(If
making payments) |
$
|
|
|
| All
parties in the Tunica ShootOut barrel race are responsible for
reading the rules and conditions of the Tunica ShootOut barrel
race and fully understanding their contents. ShootOut Productions,
Inc. assumes no liablility to those who have not read the conditions
and, having not read these conditions, they are still held to
their contents.
Signed:__________________________
Date
|
| Send
entry form w/ payment to: |
ShootOut
Productions, Inc
5650 N Broadway
Norman, OK 73069 |
| Make
Checks Payable to ShootOut Productions, Inc. |
| Entries
not paid in full and US Postmarked by April 16, 2007, must include
a $25 Late Fee per entry! |
| |
