Untitled Document

Ferry County Fair

Bulls & Barrels Entry Form

Entries must be Post marked no later than 27 th of August

Name: Address _____________________________

City State Zip Phone # ________________________

SSN# ___________________If money is won)

Horse Name ____________________________

Emergency Contact & #____________________

_______________________________________

Checks Payable to: Ferry Co. Fair

If you have questions please call :

Rhonda @ 1-509-775-0238

Mail all Entries and Waivers to Rhonda Dal Balcon

P.O. Box 403

Republic, WA 99166

Please check the box for entry:

Friday Night Mini Bull Riding Ages 8-13 Added Money

$25.00 + $5.00 Office Fee

Friday Night Bull Riding Open Added Money

$40.00 + $5.00 Office Fee

4D Barrels Open NBHA Co-Sanctioned Added Money

$40.00 + $5.00 Office Fee

Saturday Night Mini Bull Riding Ages 8-13 $25.00 + $5.00 Office Fee

Copy & Paste to Print

Ferry County Fair Arena Events

Bull Riding/Youth Bull Riding

Participant’s Name: (Please Print)

______________________________________

Address:_______________________________________________________________________

Waiver of Liability, Assumption of Risk and Indemnity Agreement

Waiver: In consideration of being permitted to participate in any way in Ferry County Fair Arena Events and Bull Riding/Youth Bull Riding events hereinafter called “Activity”, I, for myself, my heirs, personal representatives or assigns do hereby release, waive, discharge and covenant not to sue Ferry County Fair Association, Ferry County Fair Board, Ferry County, it’s agents or employees of the before names agencies and organizations and TNT Bucking Bulls from any and all claims resulting in personal injury, accidents or illnesses, including death, and property loss arising from, but not limited to, participation in Activity .

Assumption of Risk : Participation in Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from the following, but not limited to, 1) minor injuries such as scratches, bruises and sprains to 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and even death.

I have read the previous paragraph and I know, understand and appreciate

these and other risks that are inherent in Activity. I hereby assert that my

participation is voluntary and that I knowingly assume all such risks .

Indemnification and Hold Harmless: I also agree to indemnify and hold harmless Ferry County Fair Association Ferry County Fair Board, Ferry County, it’s agents or employees of the before names agencies and organizations and TNT Bucking Bulls from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in Activity and to reimburse them for any such expenses incurred.

Assurances: The undersigned has full power, authority capacity and right without limitation to execute, deliver and perform this release; provided, however, that participants under Eighteen (18) years of age must have this document signed by their parent or guardian in front of a notary public.

Acknowledgement of Understanding: I have read this waiver of liability, assumption of risk and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

Binding Effect: This release and covenant contained herein shall be binding upon the undersigned and the undersigned’s spouse, legal representatives, heirs, successors and assigns.

This release and covenant 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 as of this _______ day of ______________, _______.

My age if under 18 ______.

_____________________________________

Participant Signature

CONSENT OF PARENT OR LEGAL GUARDIAN

I, ________________________________, have read all of the above, including the Indemnification and Hold Harmless, in full. I fully understand its terms and conditions and I hereby voluntarily execute and deliver this consent for ________________________ to participate in the Youth Bull Riding event in the Ferry County Fair. I further agree to be fully bound by the terms and conditions of this agreement as a parent or legal guardian for the above named participant, and I represent that I have full power, authority, capacity and right to execute and deliver this consent and agreement on the part of said named minor child.

____________________________________________

Parent or Guardian of Minor (Please Print)

___________________________________________

Signature of Parent or Guardian of Minor Date

(To Be Notarized)

State of Washington,

County of _______________________.

I certify that I know or have satisfactory evidence that _______________________ is the person who appeared before me and said person acknowledged that he/she signed this instrument and acknowledged it to be his/her free and voluntary act for the uses and purposes mentioned in the instrument.

Dated: ______________________

_____________________________

Notary Signature

____________________________

Title

My appointment expires ________________________

HOME	Fair Home	Admission & Camping	History	Board of Directors	Friends of the Fair

Exhibitors Guide	Online Entries	Sponsors	Photos	Vendors	Volunteers