Dickinson Roughrider Youth Rodeo
June 6, 2015 l 9:00 a.m. (MDT)
Roughrider/DSU Outdoor Arena
Entries must be postmarked by June 1, 2015!
Contestant Name: ________________________________
DOB: ______________________
Parent/Guardian: _________________________________
Telephone: _________________
Address: ________________________________________
Zip Code:___________________
Ages 0-4 ($3/Event)
Ages 5-7 ($5/Event)
________ Stick Horse Race (no fee )
_______ Dummy Roping
________ Boot Race (no fee)
_______ Barrel Racing (barrels-closer with horse)
________ Goat Tail Untying-No Horse
_______ Goat Tail Tying (with horse)
________ Sheep Riding
_______ Sheep Riding
________ Barrel Racing (barrels-closer with horse) _______ Calf Scramble
________ Pole Bending (4 poles-closer with horse) ________ Pole Bending (4 poles-closer with horse)
Unassisted riders time will go ahead of lead rider. ________ Flag Race (one barrel with horse)
Ages 8-10 ($5/Event)
________ Dummy Roping
________ Barrel Racing
________ Calf Scramble
________ Goat Tying
________ Calf/Steer Riding
________ Flag Race (one barrel)
________ Pole Bending
Entry Fee Total: ___________(include)
Ages 11-13 ($5/Event)
________ Breakaway Roping
________ Barrel Racing
________ Catalog Race (can use lead line)
________ Goat Tying
________ Steer Riding
________ Flag Race (one barrel)
________ Pole Bending
Paid: ____________
Check #: _____________
ALL FORMS MUST BE NOTARIZED
Please Include Fees
 HELMETS, VESTS and LONG SLEEVES REQUIRED FOR ALL ROUGHSTOCK EVENTS
 Helmets and vest will be available
 Send entry forms to: Connie Ordahl
Questions (701) 483-5804
11451 35th Street SW
Dickinson, ND 58601
Make checks payable to:
Dickinson Showdeo Club
My child named above has my permission to compete in the Dickinson Youth Rodeo. I hereby assume and
accept full risk and responsibility for any injury or damage to my child or horse the day of this rodeo. I hereby
release the Dickinson Showdeo Club or anyone else connected with the rodeo from any liability or damages,
which may occur.
Dated this _______Day of _____________, 2015. _______________________________________________
Parent/Guardian Signature
Subscribed and sworn before me on the ______ Day of __________, 2015
State of North Dakota, County of _________________
My Commission Expires ________________
Seal
____________________________________
Notary Signature