Roundman Rodeo Company

3601 Odell School Rd

Concord, NC  28027

704-788-1858

RELEASE AND APPLICATION FORM

Assumption of risk agreement and release of all claims for anywhere in the continental USA

                    The undersigned herby specifically and expressly assumes any and all responsibility for any and all risk of damage or personal injury that my occur to the undersigned and/or any property owned by the undersigned as a contestant or participant in any events sanctioned by Roundman Rodeo Company/Stegall’s Arena which shall take place on the grounds and/or property leased, or owned or rented by Roundman Rodeo Company/Stegall’s Arena of Concord, NC or any person, company, individual, or corporation that is sanctioning a Roundman Rodeo Company/Stegall’s Arena event on any dates from January 1, 2011 thru December 31, 2011.

                    In consideration of being accepted and approved as a contestant or participant in said rodeo the undersigned hereby specifically and expressly releases and discharges Roundman Rodeo Company/Stegall’s Arena (including any and all of its owners, whether individuals, partnerships, or corporations) and/or employees of Roundman Rodeo Company/Stegall’s Arena from any and all claims, demands, rights of causes of action, past present and future, whether known or unknown, anticipated or unanticipated, and resulting from or arising out of, or incident to, the undersigned’s participation or intended participation in the rodeo’s on the dates set forth above, or resulting from or arising out of, or incident to the undersigned use or intended use of the individuals, corporation of entities hereby released.

I have read this and do fully understand and execute this Assumption of Risk Agreement and Release.

Signed this ____ day of ___________________________________2011

Name   _________________________________________________________________________________________________

Signature of Participant ____________________________________________________________________________________

Parent Signature __________________________________________________________________________________________

Notary Signature __________________________________________________________________________________________

                                     This release is signed before me______________.  My commission Expires: ______________

Printed Name: __________________________________________________________(BIRTHDAY)_______________________

Address: ________________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________________

Telephone: (HOME)_________________________________________(CELL)__________________________________________

         OPEN __          AMATEUR __           STEERS __           CALVES __          SHEEP __   CHUTE DOG__