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.
Make note of carry overs. Accepted for 2D Futurity and for 1st Open 4D on Monday from the Slot Race.

PRE-ENTRIES DUE (NOT POSTMARKED) FRIDAY MAY 16TH. On site entries accepted.

Name:

Phone :

Social Security #

UBRA #

Address:

City

State, Zip:

Email :

SATURDAY
SUNDAY
MONDAY
Open 4D
$25 Entry Fee
$500 ADDED & Division Awards

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

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

1.

1.

1.

2.

2.

2.

3.

3.

3.

2D Futurity
$15 Entry Fee
Division Awards
2D Futurity
$15 Entry Fee
Division Awards
2D Futurity
$15 Entry Fee
Division Awards

1.

1.

1.

2.

2.

2.

PeeWee
$5 Entry Fee. No Payback. Awards
PeeWee
$5 Entry Fee. No Payback. Awards
PeeWee
$5 Entry Fee. No Payback. Awards

1.

1.

1.

2.

2.

2.

Youth 4D
$10 Entry Fee
Division Awards

Youth 4D
$10 Entry Fee
Division Awards

Youth 4D
$10 Entry Fee
Division Awards

1.

1.

1.

2.

2.

2.

Open 4D
$15 Entry Fee
Division Awards

Open 4D
$15 Entry Fee
Division Awards

Open 4D
$15 Entry Fee
Division Awards

1.

1.

1.

2.

2.

2.

3.

3.

3.

Total Entry Fees: $ __________
Warm Ups $10 each $ __________ Circle: Saturday 3:00-3:30, 3:30-4:00, Sunday 8:00-8:30, 8:30-9:00 Monday 8:30-9:00
<< Available
UBRA Optional Membership
Include eligibility for $1,500 Added & $1000+ 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:
$15
 Processing Fee Per person ($10 per day for on site entries)
Shavings: $ __________ Shavings ($6 per bag)
Electrical: $ __________ Electrical hook-up ($30 wknd, $25 per night), << Electric Available
Stall Fee: $ __________ Limited stallings avaliable $40 for the first stall, $30 additional stalls. << Stalls available
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, JJ Arena 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,JJ Arena 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