THIS IS NOT AN ON-LINE SUBMISSION FORM-PLEASE PRINT THIS FORM OUT
AND BRING WITH YOU.
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Triangle Cross 4D
Barrel Race Kiplinger Arena –
McCook NE Open Runs 4-D Format
½ second splits
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Horse 1 Horse 2 Horse 3 Horse 4
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Contestant Name: Address City,State,Zip Phone #
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Total Open Entry Fees: Exh ______ x $3.00 ea Total:
Checks payable to Deb Christy
MAY ROLL TIMES TO 2ND RACE - MUST DESIGNATE BEFORE YOU RUN 1ST RACE! (if you tip, you can re-enter the 2nd race - more money in pot!) |
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Waiver: Nebraska
law provides that an equine activity sponsor, an equine professional, or any
other person shall not be liable for an injury to or the death of a
participant resulting from the inherent risks of equine activities and no
participant shall make any claim against, maintain an action against, or
recover from an equine activity sponsor.
NE ST § 25-21,249 - 253 ________________________________________________________ ___________________ Contestant signature Date (Parent or Guardian if under 18 years of age)
For more
information please contact: Deb Christy 785-543-7829 cell |
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