MARCH MADNESS 5-D BARREL RACE

ENTRY FORM

UCROSS ARENA - 8601 HIGHWAY 48 - P.O BOX 32 - COLEMAN, OK  73432

MARCH 19TH, 20TH AND 21ST - 2010

ENTRIES MUST BE POSTMARKED BY MARCH 10TH (late fees will apply after this date)

Name:____________________________________________SS#:_____________________

Address:___________________________________________________________________

City:____________________State:____________________Zip Code:__________________

Telephone #:________________________Cell Phone:_______________________________

Email Address:______________________________________________________________

ABRA #:_______________________________BBR #:______________________________

If you want to enter the Youth or Senior Incentive on Saturday and Sunday, please circle which horses you wish

to enter and indicate if it is youth or Senior by marking an S for Senior and Y for Youth.

  Youth (18 & Under) - Senior (40 & Over)

Warm Up Race - Friday 19th @ 7:00 p.m.             1._________________________________

$500 Added - Entry Fee $30.00                              2._________________________________

75% Payback                                                             3._________________________________

                                                                                     4._________________________________

Race 1 -  Saturday, March 20th @12:00 p.m.        1._________________________________

$2500 Added - Entry Fee $40.00                            2._________________________________

90% Payback - 1 Time Processing Fee $20.00    3._________________________________

Youth and Senior Incentive $20.00                           4._________________________________

Race 2 - Sunday, March 21st @ 11:00 a.m.           1._________________________________

$2500 Added - Entry Fee $40.00                             2._________________________________

90% Payback - Processing Fee applies if it           3._________________________________

wasn't pd on Sat. Youth/Senior Incentive $20.00    4._________________________________

Total Entry Fees:                 $______________        Stalls open Friday, March 19th @ 3:00 p.m.

Youth Incentive $20/day      $______________       Stalls are $15.00 night - 1 Stall per horse

Senior Incentive  $20/day   $______________       Shavings are $8.00/block

Total Stall Fees                   $______________        R.V. Hookups are $20.00 night

Shavings@ $8.00 cube      $______________       Exhibitions are $4.00 each

Target Saddle Fee             $______________        Friday Exhibitions 4 p.m. to 6:45 p.m.

Processing/Office Fee       $        20.00                     Saturday Exhibitions 9:00 a.m. to 11:45 a.m

Late Fee ($10.00 horse up                                         Sunday Exhibitions 8:00 a.m. t 10:45 a.m.

to a maximum of $40.00)    $______________      Call in or sign up for exhibitions when you get

Total Fees                            $______________       here - They will fill up FAST!!

                                                                                                          CASH ONLY AT SHOW!!!

For further information, please contact:                     Card #______________________________

Michelle Herden @ 580-937=7440                            Name on Card:_______________________

Mail Entry to:  Ucross Arena                                       Expiration Date:_____Zip Code:__________

P.O. Box 32 - Coleman, OK  73432                           (credit card will be subject to 4% fee)

IDENTIFICATION AND RELEASE OF PERSONAL INJURY.  By signing this document and by making my entry

as a participant, I hereby understand that injury/death to myself, my horse or my child is a possibility no matter

 how careful the sponsors, officers, directors or participants may be.  I as a participant (or parent/guardian)

agree to hold harmless Ucross Arena and it's owners, officers, agents, management, contractors and employees

from any expense, cause of action, damage or claim of damage (including legal fees) of any kind whatsoever which

 I might assert as a result of my (or my childs) injury, death and claim.

Signature:________________________________________________________Date__________________________

(If you are under 18 year of age, your parent or guardian must sign this form)