Entry Form

Name _______________________________________________
Address ________________________________________________
City/St/Zip ______________________________________________
Phone # __________________________
email: ____________________________                 

Region 1 Tag Saver Program # ___________________

I would like to be assigned a table
Near __________________________'s table
Describe any other table preferences:  ______________________________

* I will be bringing items to donate for door prizes (Thank you!) ___________________
* I would like to donate to the silent auction benefit or raffle (Thank you!) ___________________
Please describe items to be donated:  ___________________________________________
_________________________________________________________________________
* I would like to sponsor a class on the list (Thank You!):________________________________

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Entering/Deadlines:
Early Bird Discount - Entries received before July 1st are $30 halter/$40 halter and performance.  (Showing both CM and OF is no extra fee).

General Show entries are due by July 15th, 2005
Entries received July 16th - August 11th will be charged $10 extra per person.
Entries made on Show Day will be charged $15 extra per person.

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Amount Enclosed
*Early Bird Discount Halter Classes only ($30 before July 1st) $30.00  $__________

*Early Bird Discount Halter & Performance ($40 before July 1st) $40.00 $_________

* I'm showing Halter classes only ($35 July 2nd - 15th) $35.00 $________________
* I'm showing Halter & Performance ($45 July 2nd - 15th) $45.00  $______________
* Late Fees (Entries received July 16th - August 11th) $10.00  $____________
* Late Fees (Day of Show Registration) $15.00  $_______________
* I will be attending as a vendor only.  $20.00  $_______________
         (Tables will be on a first come first serve basis)


     Total amount enclosed (please make checks payable to Shannon Mayfield) $___________________


Please print and send completed form to:              Let Er' Buck Live Show
                                                     Shannon Mayfield
                                                      73832 Kelly Ln.
                                                      Pendleton, OR 97801
                                                                  






Please bring a list of the models that you will be showing to the show.  Thank You! 












   PLEASE SIGN AND RETURN A COPY OF THE RELEASE BELOW WITH YOUR ENTRY    

Indemnity and Release
In signing this release, I understand and agree to abide by all rules and guidelines set forth in the show rules and above.  I also agree that I will not hold the showholder, Tamastaslikt Cultural Institute, or any of her and its agents, assistants, employees, heirs, successors, or affiliates, responsible for theft, property damage, personal injury or other injury with may occur during the show or which is in anyway related to Let Er' Buck Live! Live Show, and I will indemnify and hold them harmless for any legal liability they may incur as a direct or indirect result of my show actions.



_____________________________________                                                    ____________________________________
Signature:  Guardian's Signature (if under 18)                                                         Printed Name & Date