INLAND EMPIRE BARREL RACING ASSOCIATION, INC.

2008 MEMBERSHIP APPLICATION

 

Members must reside in Spokane, Stevens, Ferry, Pend Oreille, Lincoln, Whitman, Adams,

Grant, Douglas & Okanogan Counties in the State of Washington

And Bonner, Kootenai, Shoshone and Latah Counties in the State of Idaho.

 

Name:__________________________________________________________________

 

Address: _______________________________________________________________

 

State/Zip:  Phone:_(______)_____________________

 

E-Mail:_________________________________________________________________

 

MEMBERSHIP FEE: INDIVIDUAL $25_____________FAMILY: $35___________

 

LIST NOVICE REGSTRATIONS BELOW:

 

RIDER’S NAME	HORSE NAME REG & BARN	DIVISION 2000 OR 500	LIFETIME EARNINGS
1
2
3

 

 

JUNIOR DIVISION: AGES 12 & UNDER

YOUTH DIVISION: AGES 13-18

 

RIDER’S NAME	YOUTH OR JUNIOR	CHILD’S BIRTHDATE
1
2
3

 

 

IEBRA RELEASE FORM

 

AS MEMBER OF THE IEBRA, I HEREBY AGREE TO HOLD HARMLESS AND ASSUME THE RISK OF ANY INJURY TO MYSELF, MY PROPERTY AND EVERY MINOR PERSON WHO                      ACCOMPANIES ME TO AN IEBRA SPONSORED OR CO-SPONSORED EVENT. FURTHER I WILL HOLD HARMLESS EACH EQUINE ACTIVITY SPONSOR FROM ANY CLAIM OF INJURY OR DAMAGE THAT COULD BE SUSTAINED BY MYSELF, MY PROPERTY AND EVERY MINOR    PERSON WHO ACCOMPANIES ME TO AN IEBRA SPONSORED OR CO-APPROVED EVENT.

 

MEMBER SIGNATURE:  DATE:__________

 

GUARDIAN:____________________________________________________________

 

SEND APPLICATIONS TO:

IEBRA SECRETARY/TREASURER

 

CANDI WOOD

26323 N. Hardesty Rd.

Chattaroy, WA 99003

Questions: E-mail: jctawood@pacn.com or Call 509-238-9556