Judging/Secretary/Timer Registration Form

Saturday, April 21, 2007 ● Pryor, MT

PLEASE PRINT CLEARLY

First Name_____________________________ Last Name_____________________________

Address, City, State, Zip _________________________________________________________

Home Phone __________________________ Cell/Work Phone __________________________

                   Birth Date____________________Age_______ Email Address_______________________

  **************** Registration Fee is $20 ****************

 All participants need to read and agree to the following.  Please Read Carefully

I, ________________________ (name of applicant/parent) swear the information stated above is true and accurate.  I understand that any false or untrue information on this application will result in consequences up to cancellation of registration, forfeiture of registration fee and/or prizes if any.   I understand that the NPIRA prohibits the use of alcohol, drugs profanity and the possession of weapons during any NPIRA event.  Participants will be dismissed from the clinic for disrespectful behavior, abusive language, or violence of any kind.  I understand that I or my child is participating voluntarily and at my (their) own risk.  Assumption of Risk and Release of Liability:  This is a release of liability by becoming a clinic participant; I agree to release the NPIRA and other parties from liability.  I hereby release the NPIRA, its sponsors, its instructors, its rodeo producers, its stock contractors, employees, directors, equipment or livestock donors, their agents, employees, contract personnel and representatives, as well as affiliated associations from all liability, claims, damages and expenses for injury to myself, my property, my reputation, my stock, my helpers, my equipment, or financial condition as a result of participation or failure to participate in any NPIRA event whether caused by negligence, field conditions, or any other cause.  I acknowledge that rodeo events are inherently dangerous activities.  I further acknowledge that participation in a NPIRA event exposes me to substantial and serious hazards and risks of property damage, personal injury and/or death.  I, in consideration of my participation in any capacity, does by such participation, waive, release, and covenant not to sue NPIRA, all NPIRA sponsors, all members from all claims, demands and liabilities that are known or unknown, foreseen or unforeseen.   I further, assume all liability and responsibility for any accident injury, or damage sustained or caused by myself, my helpers, my stock, and my equipment, and I agree to indemnify and hold harmless the sponsors of any NPIRA rodeo/event, the owner of the grounds in use and their representatives and employees.

  Signature of Applicant________________________       Date ____________________

 Signature of Parent/Guardian: _________________________________ (under the age of 18)

  Return by  Tuesday, April 18, 2006  to:

                           Northern Plains Indian Rodeo Association,

PO Box 62, Garryowen, MT  59031,  (406) 665-7142