Special Kids Rodeo Entry Form

Please fill out and return this form by April 13, 2010, to:

I would like my child to be considered as a participant in the Dick Foster Special Kids Rodeo on Sunday, April 25, 2010, at 12 noon (Check-In 11:00 a.m.) He/she is between the ages of six (6) and twelve (12) years. I understand that if he/she can attend, I will be responsible for his/her transportation to and from the fairgrounds and for their supervision throughout the event.

PLEASE PRINT CLEARLY:

ALL Entries MUST complete the hold harmless release below:

RELEASE

It is my understanding that participants in the Special Kids Rodeo may be photographed or interviewed for use by television, films, or printed media to demonstrate the nature of the program. 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 Special Kids Rodeo Event, and does hereby release the Auburn Wild West Stampede, Gold Country Fairgrounds, Wild West Rodeo Association, Inc., the employees, agents, and/or officers, California High School Rodeo Association, 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 of 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 Special Kids Rodeo event.

Date: ____________

Parent/Guardian Signature _______________________________________________

Any questions, please call Claudia Gibbens at (530) 887-8914