UPRA Membership Application

Applicant Information

Name

Address

Birthdate

City

State

ZIP

Cell Phone

Social Security Number Jacket Size (Sizes may vary by manufacturer and cannot be guaranteed)

Membership Type

Competing Membership ($200 + $15 convenience fee) Non-Competing Membership ($125 + $10 convenience fee) Coupon / Sponsor Code (optional)

Credit Card Payment

Credit Card Name Billing Address Card Number

Expiration Date

CVV

Or pay using:

Assumption of Risk & Release of Liability

Members acknowledge that rodeo events, including UPRA-sanctioned events, are inherently dangerous activities. Members further acknowledge that participation in a UPRA-sanctioned event (whether as a competitor, independent contractor, official, laborer, volunteer, or observer) exposes the participant to substantial and serious hazards and risks of property damage, personal injury, and/or death. Each Member, in consideration of his or her membership in the UPRA and being permitted to participate in a UPRA-sanctioned event in any capacity, agrees to assume such hazards and risks.

Each Member further agrees to discharge, waive, release, and covenant not to sue UPRA, UPRA Properties, all UPRA sponsors, all Members (including, without limitation, contestants, stock contractors, Rodeo Committees, Rodeo Producers, and Contract Personnel), and any other UPRA-sanctioned event production entity (and each party’s respective officers, directors, employees, and agents), from all claims, demands, and liabilities for any and all property damage, personal injury, and/or death arising from such Member’s participation in a UPRA-sanctioned event.

This discharge, waiver, and release includes claims, demands, and liabilities that are known or unknown, foreseen or unforeseen, future or contingent, and includes claims, demands, and liabilities arising out of the negligence of the parties released by such Member. Where permitted by applicable law, this discharge, waiver, and release also includes claims, demands, and liabilities arising out of gross negligence or willful and wanton negligence of the parties released.

This discharge, waiver, and release also includes claims, demands, and liabilities by a Member for indemnities and contributions arising from property damage, personal injury, and/or death to a third party.

If any provision of this discharge, waiver, and release is determined to be invalid for any reason, such invalidity shall not affect the validity of any other provisions, which shall remain in full force and effect as if executed without the invalid provision. All undertakings and covenants shall be binding upon each Member, his or her heirs, legal representatives, successors, and assigns.

Each Member agrees to indemnify and save and hold harmless UPRA, UPRA Properties, and all UPRA sponsors from any and all claims, demands, and liabilities for any and all property damage, personal injury, and/or death asserted by a third party (any party other than the Member, UPRA, UPRA Properties, or a UPRA sponsor) arising from such Member’s participation in a UPRA-sanctioned event.

Members also agree and understand that any winnings received from rodeos will be paid through Rodeo Secretaries and personal information may be shared with Rodeo Secretaries to expedite winnings.

I have read and agree to the full Assumption of Risk & Release of Liability and certify that all information provided is true and accurate. Applicant Signature (Digital)

Date

W-9 Form (Fillable)

Form W-9 (Rev. October 2018)
Request for Taxpayer Identification Number and Certification
Department of the Treasury — Internal Revenue Service

Name (as shown on your income tax return) Business name/disregarded entity name (if different from above) Federal tax classification (select one) ? Address (number, street, and apt. or suite no.) City, State, and ZIP code Taxpayer Identification Number (SSN or EIN) ?

Certification
Under penalties of perjury, I certify that:
1. The number shown above is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the IRS that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person; and
4. The FATCA code(s) entered on this form (if any) indicating exemption from FATCA reporting is correct. ?

Signature (Digital)

Date

Applicant Information

Membership Type

Rodeo Events

Working Personnel Cards

Credit Card Payment

Assumption of Risk & Release of Liability

W-9 Form (Fillable)

United Professional Rodeo Association