PLEASE PRINT FORM OUT & MAIL WITH PAYMENT TO: UBRA; 960 Bunyan Ave, Balsam Lake, WI 54810

One Form Per Rider - OPEN TO ANYONE AND HORSES OF ANY AGE!

Added Money & Awards for UBRA Members. Non-members eligible for regular 80% payback.

PRE-ENTRIES DUE (NOT POSTMARKED) FRIDAY APRIL 18TH. On site entries accepted, no late fees.

Name:

Phone :

Social Security #

UBRA #

Address:

City

State, Zip:

Email :

FRIDAY
SATURDAY
SUNDAY
Friday Youth 4D
$15 Entry Fee
$50 Added & Division Awards

Saturday Youth 4D
$15 Entry Fee
$50 Added & Division Awards

Sunday Youth 4D
$15 Entry Fee
$50 Added & Division Awards

1.

1.

1.

2.

2.

2.

Friday Open 4D
$25 Entry Fee
$500 ADDED & Division Awards

Saturday Open 4D
$35 Entry Fee
$1,000 ADDED & Division Awards

Sunday Open 4D
$25 Entry Fee
$500 ADDED & Division Awards

1.

1.

1.

2.

2.

2.

3.

3.

3.

Friday 2D Futurity Sidepot
$20 Entry Fee
$100 Added & Division Awards
Saturday 2D Futurity Sidepot
$20 Entry Fee
$150 Added & Division Awards
Sunday 2D Futurity Sidepot
$20 Entry Fee
$100 Added & Division Awards

1.

1.

1.

2.

2.

2.

Friday WPRA Futurity Sidepot
$50 Entry Fee
Saturday WPRA Futurity Sidepot
$50 Entry Fee $100 Added
Sunday WPRA Futurity Sidepot
$50 Entry Fee

1.

1.

1.

2.

2.

2.

Friday WPRA Derby Sidepot
$50 Entry Fee
Saturday WPRA Derby Sidepot
$50 Entry Fee $100 Added
Sunday WPRA Derby Sidepot
$50 Entry Fee

1.

1.

1.

2.

2.

2.

Total Entry Fees: $ __________
Warm Ups $10 each $ __________ Circle: Friday 4:00-4:30, 4:30-5:00, 5:00-5:30 Sat 8:00-8:30, 8:30-9:00
UBRA Optional Membership
Include eligibility for $2,500+ UBRA Tour & $735+ awards		 $ __________ 2008 UBRA Open Membership $50, Weekend only membership $25, Youth $30, Futurity $30.
Combo membership $50+$20 per adtl member/division. $100 max family membership
(ie: open & futurity = $50+$20=$70. open & futurity + youth = $70+$20=$90.)
Office Fee:
$_________
 Processing Fee Per person: $30 for weekend or $10 per day
Other $ __________ Shavings ($6 per bag), Electrical hook-up ($30 wknd, $25 per night)
Stall Fee: $ __________ $50 for the first stall, $40 per adtl stall
Total Fees: $ __________
Make Checks Payable to: UBRA ~ Send entries & checks to: UBRA; 960 Bunyan Ave, Balsam Lake, WI 54810

I understand the United Barrel Racing LLC, I 90 Expo Center and the event staff, are not responsible for any loss or damage that may occur to me, my horse, and any of my family members or property. It is my responsible to carry insurance on all this things and I agree to hold harmless United Barrel Racing LLC, I 90 Expo Center and the event staff for any loss that I may incur at this event.

_______________________________________________ Date ____________
Signature (18 or under parent or legal guardian must sign)

We're glad you're coming - drive carefully!  Questions contact Jessica (715) 857-6343 or info@ubra.org