2012 AWWS Kids Dummy Roping Competition Entry Form

Please read the Event Rules before submitting this Entry Form.

Please fill out and return this form via mail, including your check for the $20 entry fee, (payable to "AWWS Rodeo") by Wednesday, April 18th, to:

AWWS RODEO COMMITTEE
Attention: Daphne Van Stavern
PO Box 1063
Lincoln, CA 95648

I would like my child to be entered as a participant in the 2012 AWWS Kids Dummy Roping Competition on April 25, 2012, at 6:30pm (Check-in at 6:00pm.) I understand that I will be responsible for his/her transportation to and from the event venue and for their supervision throughout the event.

PLEASE PRINT CLEARLY:

Child's Name Child's Age on Event Day

Participated before?    checkbox Yes    checkbox No
Parent/Guardian Name
Mailing Address City State Zip
Work Phone Home Phone Cell Phone
Parent/Guardian Signature

ALL Entries MUST complete the hold harmless release below:

RELEASE

The undersigned does hereby voluntarily assume all risks arising out of and/or connected with his/her child's participation in the Auburn Wild West Stampede Kids Dummy Roping event, and does hereby release the Auburn Wild West Stampede, Wild West Rodeo Association, Inc., Magnussen Dodge, the employees, agents and/or officers, and all other persons associated with the organizations, for any and all claims and causes of action that may result in any injury to the undersigned or to the participating child which has been sustained or may be sustained, and from any and all damages to property belonging to the undersigned that may be a result of his/her participation in the Auburn Wild West Stampede Kids Dummy Roping event.

Date: ____________

Parent/Guardian Signature _______________________________________________

Any questions, please contact Daphne Van Stavern via email.