PESI Offspring Enrollment Form

Women’s Professional Rodeo Association World Championship Barrel Racing® PESI Offspring Enrollment Form

PLEASE SUBMIT FORM TO: HORSE INFORMATION

WPRA OFFICE Foal Name 431 South Cascade Registration Number Date of Birth Colorado Springs, CO 80903 Sire ATTN: PESI Processing Dam Dam Sire

• If paying by check, $10 cash/check OWNER INFORMATION discount already applied. Write check for amount below. Owner Name • No cash/check discount applied if Mailing Address Street Address 1

paying by credit card—add $10 to Street Address 2 the amount below. City State/Province Zip I WILL PAY BY: Phone ( ) Phone 2 ( ) Fax ( ) Check* Credit Card** Email Social Security # (for 1099) Visa MasterCard Discover AMEX Card Number: OFFSPRING ENROLLMENT

During the first year of a stallion’s participation, offspring of all ages shall be accepted for $150 Security Code: per horse. Expiration Date: Billing Address: Offspring of currently enrolled stallions and offspring of stallions who have dropped out the PESI program, but who are the resulting offspring from a season during which a stallion was enrolled will City: be accepted as follows: State: Zip: • Weanling: $150 PAYMENT MUST BE RECEIVED • Yearling: $200 BEFORE ENROLLMENT WILL • 2 Years: $250 BE PROCESSED. • 3 Years: $275 • 4 & 5 Years: $300 • 6 Years & Older: $325 FOR OFFICE USE ONLY Received REQUIRED ITEMS: Paid $ Must enclose a copy of both sides of the horse’s registration papers before enrollment is processed. Check # NOTE: An enrollment sticker will be mailed when horse is paid in full and WPRA has all required paperwork. Authorized

No Substitutions. No Refunds. By enrolling in the Pro Elite Sire Incentive Program, I hereby accept and agree to abide by any and all PESI Guidelines, which can be found at http://www.wpra.com/pdfs/Pro_Elite_ Sire_Incentive_Guidelines.pdf , including the Release and Hold Harmless provisions as set forth in section VIII General Rules. The Guidelines are subject to amendment without notice. All parties (owners & riders) involved in the PESI program are responsible for reading and complying with the Guidelines.

Signature Date