Mississippi Junior High Rodeo

MISSISSIPPI JUNIOR HIGH RODEO LAZY JII November 11, 2017- 9:00 a.m. Brookhaven, , Mississippi

NAME GRADE IN SCHOOL _____ AGE ______

ADDRESS SCHOOL ______

HOME PHONE ______

!! We, the parents of ______(name of contestant), in consideration of being granted the right and privilege to participate in the Junior Rodeo being duly sworn on oath, do hereby give permission for the contestant to enter and participate in said rodeo. We give the ______(local) hospital and the physicians on the medical staff of the hospital permission to administer necessary emergency treatment for the injuries he or she may incur while participating in the ______Junior Rodeo. We hereby release the (local) hospital, physicians on the medical staff and Rodeo Sponsors from all and any liability. SIGNED AND FATHER’S SIGNATURE MOTHER’S SIGNATURE

CONTESTANT’S SIGNATURE PARENT OR GUARDIAN MUST SIGN NEXT TO EACH EVENT ENTERED!! BOYS EVENTS FEES GIRLS EVENTS FEES

ADMINISTRATIVE FEES (REQUIRED) $20 ADMINISTRATIVE FEES (REQUIRED) $20

BOYS GOAT TYING $25 GIRLS GOAT TYING $25 BOYS BREAKAWAY ROPING $25 POLE BENDING $25 BOYS TIEDOWN ROPING $25 GIRLS BREAKAWAY ROPING $25 6, 7, 8TH grade cinch points yes no (circle one) GIRLS BARREL RACE $25 RIBBON ROPING $25 RIBBON ROPING PARTNER PARTNER $25 TEAM ROPING HEADER HEELER $25 TEAM ROPING HEADER HEELER PARTNER PARTNER $25 CHUTE DOGGING $25 6TH GRADE AND UNDER STEER RIDING $25 SADDLE STEER RIDING $25 BAREBACK STEER RIDING $25 BULL RIDING $25 CINCH DIVISION CINCH DIVISION Team Roping Header Heeler Team Roping Header Heeler PARTNER $25 PARTNER $25

MAIL ENTRIES TO: DOROTHY BROOKS ENTRY FORM WILL BE CONSIDERED INCOMPLETE 89 EMILE DAVIS RD WITHOUT ALL FEES AND SIGNATURES! Poplarville, MS 39470 CHECK OR MONEY ORDER PAYABLE TO: MJHSRA (MS JR. HIGH SCHOOL RODEO ASSOCIATION) **ALL ENTRIES MUST BE POSTMARKED on or before TUESDAY OCTOBER 24, 2017 CURRENT COGGINS REQUIRED FOR HORSE TO ENTER GROUNDS RODEO 5