SOUTHERN COLORADO BARREL RACING ASSOCIATION

MEMBERSHIP APPLICATION

_______$35 Individual membership

_______$45 Family membership. Family members must reside within the same household.

NOTE: All members will additionally responsible for an awards donation by April 1^st (see rulebook for details)

Name(s) ___________________________________________Date(s) of Birth______________

Address: _________________________________________________________________

City: _________________________________________State _______ Zip ____________

Phone: _______________________________________

Email ________________________________ Fax:_______________________________

For Youth Members Only:

Parent or Guardian Name ________________________________________________________________

Address (if different than above) ___________________________________________________________

Phone ( if different than above) ____________________________________________________________

Please check which division you wish to compete in and have points counted toward:

_______OPEN _______50 + ________YOUTH (18 and under)

Please check below if you are nominating a Novice Horse and will be counting points in this division:

_________ NOVICE HORSE (Note: Must complete and attach Novice Horse Nomination form)

Horse cannot have won more than $1000 in barrel racing history)

Member’s Signature: ____________________________________________________________________

Signature of Youth’s Parent or Legal Guardian________________________________________________

Send all applications plus novice forms (if applicable) with membership fee to:

Patty McCullar

8425 Brule Rd. Checks payable to SCBRA

Colorado Springs, CO 80908