Southern Extreme Bull Riders Association, L.L.C.

2008 Membership Application

Please Print Legibly. This application must be filled out completely, signed and submitted to Southern Extreme Bull Riders Association, LLC. (SEBRA), 6111 Canter Road Archdale, NC 27263 (336) 861-2219 / Fax (336) 431-2826

Date: ___________Renewal: Yes ____ No ____Telephone# (_____) ______________________

Name: _______________________________________ Cell Phone# (_____) ________________

Address____________________________________ City _______________ST _____Zip_______

Email Address __________________________________Birth Date __________________Age____

Coat Size __________Shirt Size __________Boot Size ____________Jean Size____________

Rookie~ Yes____ No____ To be eligible for rookie status you must be a first year member and been riding for less than 5 years.

Waiver & Release

By making application to join the Southern Extreme Bull Riders Association, Applicant agrees to participate in SEBRA sanctioned events at Applicants own risk. Applicant hereby releases and discharges SEBRA and its directors, officers, representatives, employees, stock contractors, producers and agents from liability, loss, claims, damages and expenses for injuries to person, property, reputation or financial condition as a result of or in any way relating to Applicants participation or failure to participate in any SEBRA sanctioned event, whether caused by negligence, by arena or facility conditions, by the conduct of the SEBRA sanctioned events of the administration or failure to enforce any SEBRA rules, regulations or guidelines, or otherwise. Applicant knows and agrees that by his application on this form he completely releases SEBRA and its directors, officers, representatives, employees and agents from any liability, including negligence. Applicant voluntarily chooses to participate in SEBRA sanctioned events, and freely and willingly consents to same. Applicant further acknowledges that he has no absolute property or other right to participate in SEBRA events. Applicants agree to follow and be bound by the rules, regulations, and guidelines of the SEBRA as amended from time to time. Applicant agrees that his sole and exclusive remedy for any disputes is appeal to the SEBRA appeals board pursuant to SEBRA appeal procedures contained in the SEBRA Rule Book and agrees that all decisions of the appeals committee are final and conclusive.

(Check type of Membership requested)

Contestant: $120.00__ Producer: $120.00__ Bull Fighter: $120.00__

Stock Contractor: $120.00__ Judge: $120.00__ Photographer: $50.00__

Stock Contractor & Producer: $180___ Announcer: $120.00___ Spec. Act: $120.00__

Secretary: $120.00___

Application must be notarized if applicant is less than 18 yrs of age & signed by parent or guardian.

Unscribed to and sworn this_____ Day of________________2008

My Commission Expires: _____________________________________

Notary Public Signature: ______________________________________

*Applicant Signature: __________________________________________Date:______________

*Parent Signature (If Under 18) X_________________________________Date:______________

Check form of payment: Cash: ___ Check#_____ MasterCard: ___Visa: ___ Money Order #________

Complete and sign next page for Visa/M.C. payment.

Additional $10 administrative charge for payments applies to credit card.

Credit Card #: ___________________________________________________Exp. Date:_____________

(Required) Last 3 Digits of Code on Back of Card________

(Required) Name on Card and address that your financial institution has listed for you as the billing address.

Name:_________________________________Address:___________________________________________

City:_______________________________________State:____________ Zip:______________________

Signature:________________________________________________Date:_________________________

Office Use Only: Date Received_________ Card#_________

www.sebranow.com Bio Information

Please provide the following for the sebra website. E-mail mugshot photo in long sleeve shirt and cowboy hat to Tom Smith at tom@sebranow.com Information will be used on cowboy profiles and personnel sections for Contractors, Judges, and Ect.

Name: _____________________________________________________

Hometown: _________________________________________________

Birthday: ___________________________________________________

Height: _____________________________________________________

Weight: ____________________________________________________

Hobbies / Interests / Other Careers / Ect. / Rodeo History_____________

____________________________________________________________

Awards: ____________________________________________________

Sponsors: ___________________________________________________