Special
Needs Rodeo Entry Form
Please fill out and return this form by August 3, 2017, to:
Candyce Meriwether
519 South 1070 East
Heber, Utah 84032
I would like my child to be considered as a participant in the Mountain Valley
Stampede Rodeo on Friday, August 3, 2018 at 10 am (check-in at 9:30 am).
Participants in the Princess Contest will need to check in at 8:30 am. Princess
Contest begins at 9 am. Rodeo limited to first 100 participants.
PLEASE PRINT CLEARLY:
Child’s Name:______________________________ Child’s Age:_____
Physical Limitations:__________________________ Height:_______Weight:_______
Parent/Guardian Name:_________________________________________________________
Mailing
Address:_________________________________City:____________State:____Zip:______
Work Phone:_________________Home Phone:________________Cell
Phone:________________
Parent/Guardian
Signature_______________________________________________________
If you would like your child to participate and be acknowledged in the Mountain Valley Stampede
Rodeo on Friday, August 3 at 7:00 pm, you can purchase discounted rodeo
tickets. Discounted family pass for 4 is $30.00. Each additional ticket will be
$8.00 each. Your participant in the Special Needs Rodeo will not have to
purchase a ticket. Please indicate how many tickets you would like to purchase
and include a check or money order with entry form. Make checks payable to
Mountain Valley Stampede Rodeo
Mountain Valley Stampede evening PRCA Rodeo Tickets#______Family pass @$30.00
______#@ $8.00 = $_____
Enter your e-mail address _____________________________________
LIABILITY WAIVER & RELEASE In consideration of my child's participation in
the above event, I, the undersigned parent/guardian agree and acknowledge that
there are hazards associated with my child's participation in this activity,
including but not limited to physical injury or death. I fully assume all risks
associated with my child's participation in this activity. I hereby waive,
release, and discharge for myself, my family members, heirs, administrators and
assigns any and all rights and claims which may accrue to me or my child,
against Wasatch County, its officers, employees, volunteers and agents
(hereinafter the County). Further, I will indemnify and hold the County
harmless from all liability, and provide for the defense of the County, in the
event that the County is sued as a result of my child's participation. If my
child is injured and requires medical care, I consent to such care. I hereby
certify that I have read and understand the foregoing legal document and sign
it knowingly, willingly, and voluntarily.
Parent/Guardian Signature_________________________________________________
Date_________________________________________________
Special Needs Rodeo Princess
Entry Form
Please fill out and return this form by August 1, 2016, to:
Candyce Meriwether
519 South 1070 East
Heber, Utah 84032
I would like my child to be a participant in the Mountain Valley Stampede Rodeo
Princess Contest on Friday, August 3, 2018. Participants in the Princess
Contest will need to check in at 8:30 am. Princess Contest begins at 9 am.
PLEASE PRINT CLEARLY:
Child’s Name:______________________________ Child’s Age:_____
Physical Limitations:__________________________
Interests/Talents_____________________________________________________________
Parent/Guardian Name:_________________________________________________________
Mailing
Address:_________________________________City:____________State:____Zip:______
Work Phone:_________________Home Phone:________________Cell
Phone:________________
Parent/Guardian Signature_______________________________________________________
Contestants should be dressed in their western wear or best dress.They will be
introduced and answer one question from our judges.
If you would like your child to participate and be acknlowleged in the Mountain Valley Stampede
Rodeo on Friday, August 3, at 7:00 pm, you can purchase discounted rodeo
tickets. Discounted family pass for 4 is $30.00. Each additional ticket will be
$8.00 each. Your participant in the Special Needs Rodeo will not have to
purchase a ticket. Please indicate how many tickets you would like to purchase
and include a check or money order with entry form. Make checks payable to
Mountain Valley Stampede Rodeo
Mountain Valley Stampede evening PRCA Rodeo Tickets#______Family pass @$30.00
______#@ $8.00 = $_____
Enter your e-mail address _____________________________________
LIABILITY WAIVER & RELEASE In consideration of my child's participation in
the above event, I, the undersigned parent/guardian agree and acknowledge that
there are hazards associated with my child's participation in this activity,
including but not limited to physical injury or death. I fully assume all risks
associated with my child's participation in this activity. I hereby waive,
release, and discharge for myself, my family members, heirs, administrators and
assigns any and all rights and claims which may accrue to me or my child,
against Wasatch County, its officers, employees, volunteers and agents
(hereinafter the County). Further, I will indemnify and hold the County
harmless from all liability, and provide for the defense of the County, in the
event that the County is sued as a result of my child's participation. If my
child is injured and requires medical care, I consent to such care. I hereby
certify that I have read and understand the foregoing legal document and sign
it knowingly, willingly, and voluntarily.
Parent/Guardian Signature_________________________________________________
Date_________________________________________________
Carnival Ticket Form
All Carnival Tickets must be purchased on or before July 15, 2018
Please fill out and return this form with your money as soon as possible as tickets run out quickly. Send to:
Candyce Meriwether
519 South 1070 East
Heber, Utah 84032
PLEASE PRINT CLEARLY:
Name:__________________________________________
Mailing
Address:_________________________________City:____________State:____Zip:______
Number of tickets____________@$18.00 each=_________________________________
Make checks payable to: Mountain Valley Stampede