Lil Cowpoke Rodeo Association

Mail application to: LCRA – 12651 Cow Trail Lane, Ft. Myers, FL  33905

                                JlHggnbthm@aol.com  239-340-9781 / 239-693-1558

Under Florida Law, an equine professional is not liable for any injury to or death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to Florida Statutes.

2008 LCRA – Contestant Membership Application

  Lil Cowpoke Membership Fee $ 30               Cowpoke Membership Fee $40.00 
              

 Wrangler Membership Fee $50                      Cowboy Membership Fee  $60.00

 male       female              new membership application          renewal membership

Contestant Name:

_________________________________________________________________________________

          
____________________________________ (nickname)

Mailing Address: _________________________________________________________________________

City: ______________________________________   State ________  Zip Code ________________

Phone # ( _____) ____________________      Date of Birth (M/D/Y) _________/________/_________

Email Address: __________________________________________________________

DID A CURRENT LCRA MEMBER ENCOURAGE YOU TO JOIN?      YES        NO If yes, please provide that member’s name here: _________________________________________________ ______

 

ATTENTION NEW MEMBERS:  We cannot process this application without a copy of contestant’s birth certificate.   Membership fees are non-refundable and non-transferable.  No credit cards accepted.

PARENT AND CONSENT SIGNATURES ARE REQUIRED, REGARDLESS OF AGE, TO PROCESS CONTESTANT MEMBERSHIP APPLICATION.

 consent signed and on record

___________________________________________      ________________________________________

Parent or guardian signature                                                         printed name of parent or guardian