Panhandle Peacemakers

Panhandle Peacemakers CMSA

Entry Form

Event

Event Name

Event Date

Rider

CMSA Number

CMSA Class

First Name

Last Name

Alias

Address

City

State Zip

Telephone

E-mail

Horse

Horse's Name

Horse's Breed

Horse's Sex

Biography (you can copy & paste this from your word processor)

Entry: Men, Ladies, Juniors - Wranglers name:

How many Stalls?:

How many Tack Stalls?:

Extra Shavings?:

Entry for 3D Total: (Stages 1 & 2):

Team:

Rifle Jackpot:

Cavalry Jackpot:

RV Sites:

Exhibition run:

TOTAL

Mail a check to:

PPCMSA

c/o Kathi Lee Kilpatrick

2219 Kilpatrick Lane

Sneads, Florida 32460

LIABILITY RELEASE FORM

I understand that I am participating in a sport which contains dangers, and risks may arise, including but not limited to, accidental injury, the forces of nature and illness. In consideration of the right to participate in these events and the services provided for me by the Cowboy Mounted Shooting Association and its agents, I have and do hereby assume the risks associated with such events

The contestant shall, at his own expense, defend management and/or all sponsors, their members, or employees from any and all such claims and indemnify, from all liability, damage and costs arising from injuries to person or property occasioned by act or omission of the contestant.