OPEN FUTURITY $1500 added

$150 EF (Sat / Sun)

Carry Over to Open 5D

(Sat / Sun) Open Futurity

SATURDAY OPEN 5D $50 EF

$2000 Added

SUNDAY OPEN 5D $50 EF

$2000 Added

MONDAY OPEN 5D $50 EF

$5000 Added

Youth 13 & Under $25

Senior $25

WPRA Permit Only $50

Pee Wee 0 - 6 yrs No EF

TOTAL

OPEN 5D ENTRY

HORSE NAME

RIDER NAME: ____________________________________________________

ADDRESS: ______________________________________________________

__________________________________________________________________________________________

PHONE:_____________________________________EMAIL:__________________________________________

WPRA: __________________ BBR: __________________ FUTURE FORTUNES ELIGIBLE:____________________

Indemnification and Release Personal Injury: By signing this document I / We hereby agree to hold harmless Cornhusker Futurity and the Custer County Fairgrounds, its agents, management, contractors, and employees from any expense, cause of action, damage, or claim of damage, including legal fees of any kind, which I might assert as a result of my (or my child’s) injury, death or claim by participating or driving to or from this event. I further certify that I have available a current NEGATIVE EIA TEST CHART on each animal I have on the event grounds. I understand that if State and Local Authorities require presentation of said test chart at this event and I cannot present a NEGpresentation of said test chart at this event and I cannot present a NEGATIVE EIA TEST CHART per any one (1) animal, I will be responsible for any fines personally, and will be responsible for reimbursement of any fines to the event producer. YOUR SIGNATURE CONSTITUTES A RELEASE OF LIABILITY (If Minor, Parent or Guardian). I (we) hereby make application to enter the above named horse in the Cornhusker Futurity, subject to rules herein. Rules all of which I (we) have read, and agree to the provisions contained Therein as part of this contract. I (we) hereby release the above from any claim to loss to myself, rider, employees, horses and / or equipment. Full set of rules, updates, news and instructions will be on Cornhusker or equipment. Full set of rules, updates, news and instructions will be on Cornhusker Web Page. www.cornhuskerfuturity.com

TOTAL ENTRY FEES

Signature:______________________________________________________________________________________Date: ________________________

If Minor Parent/ Guardian:_______________________________________Print Name:______________________________________________________

MAKE CHECKS PAYABLE TO: CORNHUSKER BREEDERS FUTURITY LLC 82257 LINSCOTT AVE ANSELMO, NE 68813

Monday Only