Day Membership Application

Day Membership Application

MOUNT ISA INDIGENOUS RODEO CHAMPIONSHIPS QLD, 9th August 2026
Participant Details

Please fill out below details,read and sign waiver where required.
Name of Participant
Address

Street Address

Street Address Line 2
CityState Post Code
Date of Birth

DayMonthYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Risk Warning and Waiver of Liability

Name & Address of Provider: Australian Professional Rodeo Association PO Box 264, Warwick, QLD 4370
The following pages affect your legal rights and obligations. Please read these carefully and only sign if you fully understand their contents. For Participants under 18 years of age, these documents must be completed by a parent or legal guardian.

Description of Activities: RODEO

Risk Warning
I am aware that by my participation in any activities arranged by the Provider, certain risks or dangers may occur which could include:
• Physical, bodily or psychological injury or death.
• Physical exertion to which I am not accustomed.
• Failure of equipment or use of inadequate equipment.
• There may be no or inadequate facilities for treatment or transport to treatment if I am injured.
• The conditions in which the activities are conducted may vary without warning.
• I may cause injury to other persons and/or other persons may cause injury to me.

1 Provider includes the officers, employees, agents, contractors, franchisees and assigns of the Provider.
2 Activities includes all activities and services ancillary to or associated with the named Activity, both before and after the Activity, including transportation to and from the location of the Activity whether provided by the Provider or not, briefings, inductions, training, and the provision of information in all manuals, safety guidelines and other documentation provided to or made available to the Participant with respect to the Activity, familiarisation with clothing or equipment and methods of operation of equipment and the wearing and removal of any clothing or equipment associated with the Activity. Unless otherwise specified, a reference to an Activity is a reference to a recreational service or a recreational activity as defined in relevant legislation referred to herein.
Declaration and Signature

I have read carefully and understand this risk warning and waiver of liability and sign it freely and voluntarily without inducement of any kind.
Signature of Participant
Date (Participant Signature)

DayMonthYear
Date
Signature of Witness
Date (Witness)

DayMonthYear
Date
For Participants under age 18

This is to certify that I, as a parent/guardian with legal responsibility for the Participant, acknowledge, understand and accept all of the above and consent to his/her release as provided above. I release and agree to indemnify and hold harmless the A.P. R.A. Inc from any and all liabilities arising from my minor child’s involvement or participation in the Activities and/or recreational services, even if arising from the negligence of the A.P.R.A. Inc.
Signature of Legal Guardian
Date (Legal Guardian)

DayMonthYear
Date
Name of Legal Guardian (Print)
Signature of Witness
Date (Witness for Legal Guardian)

DayMonthYear
Date
Entries for the Mini Bull Ride are taken through the Mount Isa Committee

nominations@mtisarodeo.com.au
Indigenous Identification

The Mount Isa Mines Indigenous Rodeo Championships is a targeted event celebrating and showcasing Aboriginal and Torres Strait Islander rodeo competitors.
Do you identify as an Aboriginal and/or Torres Strait Islander person? (This information is required to confirm eligibility for this event.)
If your nomination is successful, you may be asked to provide confirmation of Aboriginal and/or Torres Strait Islander identity from a recognised Aboriginal or Torres Strait Islander Organisation or Elder. We respectfully recognise the importance of cultural identity and community connection and thank all competitors for supporting and celebrating Indigenous participation in rodeo.
Bank Account Details

Please provide bank account details below for Prize Money Payouts
Account Name
BSB
Account Number
Rodeo Entry Details

Please select events you wish to compete in for this rodeo. All prices shown are inclusive of GST and our payment processing costs, including Stripe fees where applicable

My Products

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Please note that Day Membership Fees and Entry Fees are not refundable.

Your entry is not valid until a confirmation email has been received from Head Office. You will receive a confirmation email when your entry is processed, this may take up to 24 hours.
Should be Empty:

Day Membership Application

Participant Details

Risk Warning and Waiver of Liability

Declaration and Signature

For Participants under age 18

Entries for the Mini Bull Ride are taken through the Mount Isa Committee

Indigenous Identification

Bank Account Details

Rodeo Entry Details

My Products

Please note that Day Membership Fees and Entry Fees are not refundable.