AAY ENTRY FORMS Click here for a printable pdf entry form All-American Youth Entry Form 2021 Unique IDDate of Birth* Date Format: MM slash DD slash YYYY Required to calculate sidepots. Name First Last Entry Date Date Format: MM slash DD slash YYYY Email* PhoneSSN*Credit Card Billing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Rider Mailing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Entry OptionsEntry Horse 1 Price: $ 0.00 Entry Horse 2 Price: $ 0.00 Entry Horse 3 Price: $ 0.00 Entry Horse 4 Price: $ 0.00 How many horses will you be entering?*OneTwoThreeFourNone (stall reservation only)Horse #1 NameAAY Fees Horse 1 $200 Entry Fee $50 Sidepot $100 Pony Race Horse #2 NameAAY Fees Horse 2 $200 Entry Fee $50 Sidepot $100 Pony Race Horse #3 NameAAY Fees Horse 3 $200 Entry Fee $50 Sidepot $100 Pony Race Horse #4 NameAAY Fees Horse 4 $200 Entry Fee $50 Sidepot $100 Pony Race NOTE: You must enter the OPEN RACE in order to enter a SIDE POT. Please correct your entry if you have entered a SIDE POT without entering the corresponding OPEN RACE.Stall Reservations ($85 ea)Stalls Price: $ 85.00 Quantity: Late Fees Price: $ 0.00 Online Entry Fee plus AAY Text & Alerts Price: $ 3.00 Don't miss important text alerts from the LanBar Production Team! Processing Fee ($20 per horse) Price: $ 20.00 Subtotal $ 0.00 Coupon Credit Card Fees $ 0.00 Total $ 0.00 REQUIRED LIABILITY RELEASE* Yes, I agree Under MIssissippi law, an equine activity sponsor is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risk of equine activities. I understand that every effort will be made to ensure the safety of each contestant and his/her horse(s). I hereby release LanBar Barrel Racing, Kirk-Fordice Equestrian and all sponsors involved. I also acknowledge that I have read, understand, and agree to abide by the rules ofLan Bar Barrel Racing and any ground rules enforced for specific events. (See website and/or registration table for rules and complete event details.)Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Side Pot Eligibility TeenSide Pot Eligibility YouthComments to ProducerPlease check your email after submitting your entry for confirmation.
