Box Butte County Fair

Box Butte County Fair Extreme Enduro-Cross August 7, 2016 Box Butte Fairgrounds

Times: Price: Only ONE entry per form Sign-up: 5:00pm Entry: $25 Practice: 6:00pm Quads: $25 Main Event 7:30pm Pit Passes: $15

Name______Age______

Address______

City______State______Zip______

Phone number______

Motorcycle______CC______

Bike number______(If you do not have a bike number you need to make one)

In consideration of my being allowed to participate in the Box Butte County Fair Extreme Enduro-Cross, I agree to comply with all the rules governing this contest, using common sense motorcycle safety. I agree to assume all risks for any loss or injury to myself or property which may arise from my participation in this contest. I also agree to release indemnity and hold harmless the Box Butte County Ag. Society and its Board of Directors from any claim, loss or experience rising from my participation in this event. I have read and fully understand this entry form.

Riders Signature______

Parent/Guardian Signature______Date______

Notary Signature______

Please mail entry forms to: Box Butte County Fair PO BOX 608 Hemingford, NE 69348