Flying
DX Youth Rodeo Association
Membership Form
Winter Series 2008
Child
1: ______________________________________ Child 2:
Coat Size _____________ Shirt Size _______________ Coat Size
Shirt Size
Grade in School as of Aug 08______ Date of Birth_______
Grade in School as of Aug 08 Date of Birth
Is contestant Male ______ Female ______ Is Contestant Male
Female
Child 3: ______________________________________ Child 4:
Coat Size _____________ Shirt Size ______________ Coat Size
Shirt Size
Grade in School as of Aug 08______ Date of Birth_____
Grade in School as of Aug 08 Date of Birth
Is contestant Male ______ Female ______ Is Contestant Male
Female
Address: ___________________________________________
City: ______________________ State: _____ Zip: ________
Phone: ____________________________________________
Email address:
Signature Parent/ Guardian:
________________________________________________________
Date Membership Paid:
_____________________________
1 membership $20, 2 members $30, 3 members $40, 4 members $50. Non-Refundable.
Amount Paid __________________________ Date: __________________________
** Copy of Birth Certificate and Grade Card must be on file by Finals. No
exceptions. *
Rodeo News Magazine Subscription $ 15.00 per family for one year. Paid:___________ Date:__________. (This is mandatory)
Parent Consent Form
As consideration for being allowed to participate and/or compete in the Flying
DX events, I the undersigned agree to the following:
Acknowledgement of Risk: The undersigned acknowledges that the Flying DX
events are dangerous activities and that the participation in said events, as
either a contestant, an employee or volunteer, exposes the participant to a
substantial and serious risk or property damage, persona injury or death. The
undersigned expressly acknowledges that his/her participation will involve such
a hazard.
Release of Sponsors: The undersigned being fully aware that participation
in the Flying DX events will expose him/her to a substantial and serious risk of
property damage and/or personal injury or death, hereby releases all sponsors
from liability for any and all property damage, personal injuries or other
claims arising from the undersigned’s participation in said event including
those that are know and unknown, foreseen and unforeseen, future or contingent.
Covenant Not to Sue: The undersigned covenants that the undersigned shall
not now or at any time in the future, directly or indirectly, commence or
prosecute any action, suit or other proceeding against the sponsors (or their
officers, directors, employees, agents or affiliates) concerning, arising out
of, or related to the actions, causes or action, claims and demands hereby
waived, released or discharged by the undersigned.
Assurances: The undersigned has full power, authority, capacity and right
without limitation to execute, deliver and perform this release.
Rules: The undersigned agrees to all of the rules of the Flying DX.
Binding Effect: This release shall be binding upon the undersigned and
the undersigned’s spouse, legal representatives, heirs, successors and assigns.
Note: Participants under 18 years of age must have the following signed by their
parents or guardian:
Consent to Treat: I hereby give the affiliated EMS the right to treat the above
listed child, which I am the parent or guardian of should the need arise.
I have read the above release in full. I totally understand its terms and
conditions, and I hereby voluntarily execute and deliver this consent to
contestant’s participation in the Flying DX events. I further agree to be fully
bound by the release’s terms and conditions in both by individual capacity and
in my capacity as parent or legal guardian for the undersigned.
Parents/ Guardian
Signature:___________________________________________________________________________ Date
* There will be no tolerance of anyone confronting the judges at any time. Refer
to rulebook for consequences. *