2010 Pioneer Day Celebration - MUTTIN BUSTIN Registration
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1. 2010 Pioneer Day MUTTIN BUSTIN Registration Form

The Pocatello Idaho Pioneer Day Celebration is delighted to have you join us on July 24, 2010 for MUTTIN BUSTIN!

The event will begin at 11:30, July 24, 2010 at the fairgrounds. Use this web site to pre-register and check-in at 11:45 at the grand stand entrance. Admission and registration is free.

RULES:

1. Child must be 4 to 8 years old and weigh LESS THAN 50 pounds at weigh in.
2. Child safety helmets and vest must be worn and will be provided.
3. No spurs allowed
4. Child may request a girth rope (put on by Event Personnel only) or take a wool hold.
5. Child is to grasp with both hands during ride. (No extra points are awarded for one handed riding).
6. Child must stay mounted for 6 seconds in order to score and receive ride points.
7. Ride points are awarded by ride Judge for form, difficulty, speed,and quality of ride.
8. Decision of Judges is absolutely final. Winners will be announced over the loud speaker.
9. Trophies will be awarded to the top three riders; all other riders will receive Participant Ribbons.

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1. PARENT contact information

PARENT contact information Parent's Full Name:
Address:
City/Town:
State:
ZIP:
Email Address
Cell Phone number:
Other Phone number:

(Due to programming limitations you can only register ONE TIME from any one given computer so PLEASE enter all persons on this form who wish to participate. Use commas to separate information (ie. Charlie, Billy) If you attempt to enter a second registration you will be blocked so please use a different computer or contact a member of the Pioneer Day Committee for help.)

2. 2nd CHILD'S INFORMATION

2nd CHILD'S INFORMATION Child's Name
Child's Age
Child's Sex
Child's Weight

3. LIABILITY RELEASE FORM

Note: The following must be electronically signed by child’s parent or legal guardian.

AGREEMENT: As a consideration for being allowed to participate in the Pioneer Day Celebration Mutton Busting Event I, the undersigned: Acknowledge that participation in the event may expose the contestant to substantial and serious risk of property damage, personal injury or death; I expressly acknowledge that this event will involve such hazards.

I RELEASE ALL EVENT SPONSORS: From liability for any and all property damages, personal injuries and other claims arising from participation by the undersigned or the undersigned’s child in the event, including those that are known and unknown, foreseen and unforeseen, future or contingent.

COVENANTS NOT TO SUE: On behalf of the undersigned and the undersigned’s child, the undersigned covenants that neither he/she nor his/her child shall not now, nor at any time in the future, directly or indirectly, commence or prosecute any action, suit or other proceeding against the sponsors their officers, directors, employees, agents, or affiliates, concerning, arising out of, or related to any action, cause of action, claim or demand hereby waived, released or discharged.

ASSURANCE: The undersigned has full power, authority, capacity and right, without limitations, to execute, deliver and perform this release.

BINDING EFFECT: This release shall be binding upon the undersigned and undersigned’s spouse, children, legal representative, heirs, successors, and assigns. This release has been carefully and fully read by the undersigned and the undersigned fully understands its terms and conditions and has voluntarily executed and delivered this release.

PARENTAL RESPONSIBILITY: I, the undersigned acknowledge that responsibility for my safety and the safety of my child remains at all times with me, and that the releases herein do not assume any responsibility for my safety and/or the safety of my child.

LIABILITY RELEASE FORM Note: The following must be electronically signed by child’s parent or legal guardian. AGREEMENT: As a consideration for being allowed to participate in the Pioneer Day Celebration Mutton Busting Event I, the undersigned: Acknowledge that participation in the event may expose the contestant to substantial and serious risk of property damage, personal injury or death; I expressly acknowledge that this event will involve such hazards. I RELEASE ALL EVENT SPONSORS: From liability for any and all property damages, personal injuries and other claims arising from participation by the undersigned or the undersigned’s child in the event, including those that are known and unknown, foreseen and unforeseen, future or contingent. COVENANTS NOT TO SUE: On behalf of the undersigned and the undersigned’s child, the undersigned covenants that neither he/she nor his/her child shall not now, nor at any time in the future, directly or indirectly, commence or prosecute any action, suit or other proceeding against the sponsors their officers, directors, employees, agents, or affiliates, concerning, arising out of, or related to any action, cause of action, claim or demand hereby waived, released or discharged. ASSURANCE: The undersigned has full power, authority, capacity and right, without limitations, to execute, deliver and perform this release. BINDING EFFECT: This release shall be binding upon the undersigned and undersigned’s spouse, children, legal representative, heirs, successors, and assigns. This release has been carefully and fully read by the undersigned and the undersigned fully understands its terms and conditions and has voluntarily executed and delivered this release. PARENTAL RESPONSIBILITY: I, the undersigned acknowledge that responsibility for my safety and the safety of my child remains at all times with me, and that the releases herein do not assume any responsibility for my safety and/or the safety of my child. YES, I agree

2010 Pioneer Day Celebration - MUTTIN BUSTIN RegistrationExit this survey

1. 2010 Pioneer Day MUTTIN BUSTIN Registration Form

*1. PARENT contact information

2. 2nd CHILD'S INFORMATION

2010 Pioneer Day Celebration - MUTTIN BUSTIN Registration
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*
1. PARENT contact information