OUTBACK BARREL RACING ASSOCIATION

OBRA -01

MEMBERSHIP APPLICATION

YEAR ______________

DATE:

Membership runs from January to December irregardless of when you pay your dues.

Office Use

NAME:

MEM #:

MAILING

ADDRESS:

E-MAIL:

BIRTH DATE:

PHONE/CELL#

TYPE:

Amount paid and Check #:

NON-COMPETING

$15

SINGLE

$35

FAMILY:

$55

(Three per family add $10 for each additional family member)

Family membership detail:

Office Use

Name:

D.O.B.

MEM #:

Name:

D.O.B.

MEM #:

Name:

D.O.B.

MEM #:

Name:

D.O.B.

MEM #:

PURPOSE AND OBJECTIVES: The primary purpose and objective of this organization

is to promote barrel racing as a sport and a family event. To enjoy the use of horses

and further the camaraderie of family and friends. To treat each other and and our

property with respect and dignity, and most of all to have some fun!!

WAIVER: In submitting my application for membership in the Outback Barrel Racing

Association, I hereby release the show organizer, the OBRA (Outback Barrel Racing

Association) and any official employee, director or agent of the same, from any

claim or right for damages, which may occur to myself, family member, my horse(s)

or personal property that may arise as a result of my membership in this organization.

SIGNATURE:

(If under the age of 18, must also be signed by parent or legal guardian)

SIGNATURE:

(All adults in family membership must sign application)

Mail to: Kay Haugenoe PO Box 145, Wolf Point, MT 59201

Wrangler Notify Date:__________ Wrangler Subscription Check #___________Date:______________