Interstates Rodeo Association
118 Washington Street
Grand River, Iowa 50108
641-773-5232

2007 Application
Print Clearly

Date:________________ After April 1st add $10.00
Contestant/Personnel: $75.00
(Includes 5 saddle raffle tickets)		 Timers (Only): $45.00 Newsletter: $25.00
  Circle One:   New     Old
Name:_____________________________________ IRA #:_________________
Address:___________________________________ City:___________________
State:________________ Zip:_____________ Phone:____________________
Date of Birth:________________________ Soc. Sec. #:__________________________

          I work the following events:
Bareback Saddle Bronc Bull Riding Calf Roping
Forty & Over CR Break-away Barrel Racing Team Roping
Steer Wrestling Timer Judge Pick-up Man
Bull Fighter Photographer Barrel Man Specialty Act
Stock Contractor Producer Announcer Clown
Secretary Other____________________

        Signature______________________________________________

         Applicants under 21
           I certify that the age and date of birth of the below named child is correct, and I hereby consent to the participation of my/our child in the Iowa Rodeo Association, Inc. I agree            that in no event will I hold the IRA, Inc., its agents, or employees liable for injury or property damage during participation at an IRA sanctioned rodeo or while enroute to or            from an IRA sanctioned rodeo.

Applicant:_______________________________________________ Birth Date:_______________________________
Address:_______________________________________ Age:_______________________________
City & State:____________________________________________ Zip:_______________________________
Phone:__________________________________ Soc. Sec. #:____________________________________
         Parent/Guardian Signaure:_________________________________________ Must be notarized
         The foregoing instrument was acknowledged before me this __________________day of _________ 20______ by
         _____________________________________ parent or guardian of the above IRA contestant, and I certify that the above information is
         true to the best of my knowledge.
         Notary Public ____________________________________Date ____________________ My Commission Expires ___________________________

 

Home | Up Coming Events | Standings | Results | Contact Us