Winter Blast Official Entry Form

Heart O’ Texas Fair and Rodeo & C.T.B.R.A. 1st Annual

“WINTER BLAST” Pre-Enter Without Pre-Paying!! February 19, 20, 21, 2010 Heart O’ Texas Fair Complex Dodge Show Pavilion **PRE-ENTER BY FAX ONLY WITHOUT PRE- PAYING! YOU MUST CHECK IN AND **PAY AT LEAST 1 HOUR BEFORE YOUR RUN, OR A “TURN OUT” WILL BE GIVEN!

**If you don’t pay/ show on time & get a “TO”, you may run at the end with a$20 add.fee

PRE-ENTRY DEADLINE FOR 5D OPEN & 3D POLES FRIDAY FEB. 12, 2010 LATE FAX ENTRIES ACCEPTED THROUGH MONDAY FEB. 15, 2010 MAY ENTER ON SITE, LATE FEES APPLY, ENTER UNTIL LAST 25 RUNNERS

PRE-ENTRY FAX NUMBER: 512/685-1115 Draw Posted Feb. 16 *Cash or Checks Accepted for All Races. No Credit Cards Accepted. *Equal Pay Out All Races, 80% Pay Out 4D Warm Up, Open 5D, 4D Incentives & 3DPoles. *Saturday 5D Open $50 Entry, 4D Incentives $20 Entry, Pre-enter to avoid late fee or Enter on Site (late fee applies). *Friday Exhibitions $5 each, 4D Warm Up Race $30 Entry Fee,Enter on Arrival-no late fee *Saturday 3D Pole Race $30 Entry Fee, Pre-Enter to avoid Late Fee or Enter Late on Site *Sunday C.T.B.R.A. Regular Point Show-Non Members Welcome, Pre-Entries taken or enter on arrival. See C.T.B.R.A. Entry Form or visit www.ctbra.ebarrelracing.com for rules. *Stalls $15/ night, RV-$20/ night, Shavings-$9/bag, No Outside Shavings Allowed. No Reservations, See Dodge Pavilion Office Upon Arrival-Cash/Checks/Credit Cards to facility. Stall Office Opens Friday Feb.19, 9a.m.

PROCESSING FEES: $10 each for 4D Warm Up, 5D Open, 3D Poles or Exhibitions LATE FEES: $10 each for 5D Open and 3D Poles For Questions Contact: Mitzi Angelle, [email protected], 512/422-4821 Current Coggins Required at Check In. Fair Ground Drag Draw will be used.

*PLEASE PRINT

Rider Name:_______________________________________ Address:___________________________________________ City:______________________State:______Zip:_________ Phone:_____________________________________________ Date of Birth:______________________________________ **Must be Provided, 18 & Under be prepared to show proof of age if asked!

Soc.Sec#__________________________________________ **Must be provided or Entry will Not be Taken

Email:_____________________________________________ IDENTIFICATION AND RELEASE OF PERSONAL INJURY By signing this document and by making entry as a participant, I hereby understand that injury/death to myself, my horse, or my child is a possibility no matter how careful the sponsors, officers, directors or participants may be. And furthermore, I as a participant (or parent/guardian), agree to hold harmless H.O.T. Fair and Rodeo and C.T.B.R.A. and their officers, agents, management, contractors and employees from any expense, cause of action, damage, or claim of damage (including legal fees) of any kind whatsoever which I might assert as a result of my (or my Child’s) injury. I recognize that this is an Equine Sporting Event and I ( or my child/charge) are riding “at my or child’s own risk.

Signature:_________________________________________ __ Parent/Guardian:_____________________________________ Date:________________________________________________ SATURDAY

SATURDAY

(Use extra entry form if more than 5 horses)

5D OPEN 10a.m.___ x $50=________

Youth

4D Incentives ______x $20=________

Adult

3D POLES $500 ADDED!

Senior

(18 & Under)

(19-39)

(40+)

_____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse

8p.m. _____x $30=________ _____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse _____________________________________________ Horse

(4D Incentives are ½ Second Splits carried from Open)

Total Entries 5D__________ Total Incentives _________ Late Fee__________

For Office Only

Total Entries 3D Poles________ Late Fee________ Process Fee 10.00_

Process Fee 10.00 Total Fees:__________

*If you Don’t Pay/Show On Time & get a “TO” you may run at the end with $20 Add.Fee

“Turn Out” Fee $20 ___________

Total:________