KANSAS PROFESSIONAL RODEO ASSOCIATION

2017 MEMBERSHIP APPLICATION

Can fill out online and then print off and mail with check to: 

Tina Kessler, P.O. Box 159, Callaway, NE 68825

Questions - email Tina tkessler4rodeos@yahoo.com or call (308) 880-0169

For online payment of membership click here

 

NAME SOC SEC

ADDRESS

CITYSTATEZIP

HOME PH#CELL #DOB

EMAILJACKET SIZE (UNISEX SIZES)

EVENTS:  BB  SB  BR  TD  SW  BAW  LBR  TR HEADER

  RANCH BRC   TR HEELER    40/40 HEADER   40/40 HEELER


**MEMBERSHIPS WILL INCREASE $15 AFTER JUNE 1ST**

(Check membership requested)

    Membership dues $125 ($140 after June 1st) ($75 membership plus $50 finals fund)

    Youth Membership $90 ($105 after June 1st) ($40 membership plus $50 finals fund)

            Youth under 18 must complete notarized Minors Form

    Companion pass $10 (one per contestant)

    Non-contesting card $35 ($50 after June 1st) - please designate - Announcer Judge Pickupman

        Stock Contractor Bullfighter Timer Secretary Committee Other

    Check here if you qualify for rookie - (This must be your 1st year membership with the KPRA, and you

            may not have held a membership previously from other associations, other than a youth/college association.)


I agree to abide by the rules and regulations of the KANSAS PROFESSIONAL RODEO ASSOCIATION

(KPRA) and not hold the KPRA responsible for any related incidents or accidents involving the KPRA.

I hereby waive and release any and all claims against the KPRA, its officers, directors and employees.

I give the KPRA permission to publish my name and monies won in the official association

publication and on the association website.  This provision shall be binding upon said member,

his or her legal representative, heirs, successors, and assigns.

 

_________________________________________     ____________________

Signature                                                                                Date


FOR OFFICE USE ONLY:

CARD #_______________DATE REC'D_____________PAID:____________________