YBR Jackpot Barrel Race

Event Details:

Time: Sign-ups close: 3:00 pm on the day of show

Competitions Begin: 3:30 pm

Location: Yucaipa Equestrian Center

Address: 13273 California St.

Yucaipa, CA. 92399

Phone Number: 951-452-1477

Welcome to Yucaipa Barrel Racer's First Jackpot Barrel Race

Welcome to our first 80/20 YBR Jackpot Barrel Race. We want to provide you with a very lucrative experience. 5 division brackets that will have cash payouts. Buy-in is $50. If you attended the gymkhana that day, your ground fees are waived.

If you have any questions, don't hesitate to contact us at yucaipabarrelracers7@gmail.com

Name*

First NameLast Name

Horse's Name

Date

Date of Birth *

**If under the age of 18 at the time of the application, A parent or guardian will need to provide their information.

Age

Parent or Legal Guardian Name*

First NameLast Name

Parent or Legal Guardian DOB*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Preferred Contact Method

TextEmail

An ASTM/SEI equestrian helmet is required for every rider under the age of 18 while mounted, regardless of in or outside the arena. No bicycle helmets are allowed. Helmets for riders 18 and over are encouraged, but not required

I understand and agree to comply if the rider is under the age of 18

Photo and Media Authorization

Do you allow Yucaipa Barrel Racers to take photographs or videos of you, and/or your child (and/or horse, if applicable) during events, and do you understand that these images may be used for promotional purposes, including being posted on Yucaipa Barrel Racers' social media accounts and website. Do you also acknowledge and agree that you or your family will not receive any compensation for the use of these images and that they will be used solely for promoting the organization and its events.

Photo and Media Authorization*

YesNo

Payment Options:

Payment Option*

Credit Card (Processing fee applies)PayPal (Processing fee applies)Zelle (Yucaipabarrelracers7@gmail.com)Venmo (@yucaipabarrelracers7)

Signature for Release of Liability:

I, the undersigned, understand that participating in Yucaipa Barrel Racers events involves risks of injury, death, and property damage. I voluntarily assume all such risks and agree to release and hold harmless Yucaipa Barrel Racers, its organizers, officers, volunteers, and sponsors from any and all claims, liabilities, or damages that may arise from my participation in these events, including those caused by negligence.

I further agree to indemnify Yucaipa Barrel Racers and its representatives from any claims made as a result of my actions during the event. I acknowledge that I am responsible for my own safety and actions while participating and agree to follow all event rules and instructions.

By signing below, I confirm that I have read and fully understand this Release of Liability, and I agree to its terms.

**Effective March 1, 2003; all riders under 18 are REQUIRED to wear a helmet when riding at all sanctioned shows.

YBR DOES NOT PROVIDE MEDICAL INSURANCE FOR ITS MEMBERS

Signature

Credit Card Total

Payment Amount

USDDescription

Credit Card

EVENT TOTAL

Venmo Payment info: @yucaipabarrelracers7

Zelle Payment info: @yucaipabarrelracers7

11/15/2025 Jackpot Barrel Race

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