January 5-19, 2022 • The WRANGLER, Annual Breeders Edition 83
Application for Membership
MUST BE PURCHASED 5 DAYS BEFORE BOOKS OPEN!!!
Full Name _______________________________________________________________________
Mailing Address __________________________________________________________________
City____________________________ State____________________ Zip ____________________
Phone____________________________ DOB__________________________________________
Email Address ____________________________SSN#___________________________________
(Social Sec Number is required)
Events Entered:___________________________________________________________________
Do you want to receive The Wrangler publication by the above Email only. _____YES or ______NO
You can subscribe to The Wrangler for a hard copy to be mailed at horses@thewrangler.com
___Contesting $100 Before
03/31
___Contesting $120 After
03/31
___Rookie $75
___Permit $50
___Novice Rough Stock $50
___Judge $30
___Timer $30
___Bull Fighter/Pickup $30
___Announcer $30
___Secretary$30
___Photographer $100
___Stock Contractor $100
___Sub-Contractor $100
Prime Contractor signature for
Sub-Contractor with date
I have included $________ as a donation to the ICA Cowboy Crisis Fund
I am eligible for Rookie Designation: Yes _____No _______
(ROOKIE is A 1st yr cardholder who has never been a cardholder in a rodeo association other than college, high school,
Little Britches or Western States. Permit holders are not eligible for Rookie status.)
RELEASE: I swear that I will abide by all rules and regulations of the ICA, and hereby release and hold harmless that
Idaho Cowboys Assoc, Inc., all members, stock contractors, rodeo committees, employees of the same, and any or all
person connected with all ICA approved rodeos from losses, damages, or injury to me or my equipment resulting from
participation in any or all events.
Signature ___________________________________________ Date_________________________
If applicant is under 18 yrs of age this release must be signed by parents and notarized. "I hereby swear to the above
release, and expressly give my permission for my son/daughter to compete in ICA rodeos."
Signature of Parent/Guardian______________________________ Date ________________________
Notary Signature ________________________________________Date ________________________
Credit Card Payment: $4.00 Office charge Credit Card Payments
Amount $________+$4.00 =________ Card # ______________________________________________________________
Card Type________________________________ Card Expires____________Security Code _______
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H H H
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TH
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THLETIC
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