$1000 Added Dakota Hills Veterinary Clinic Open 4D
Jessie Jaymes Buckles to the Champions of each "D"

WPRA/NWBRA/UBRA Approved - $10,000 added Future Fortunes Money - www.futurefortunesinc.com
Saturday September 11th, 2010 - Pennington County Event Center
Pre-entries must be received by September 1st, 2010         $45
Mail to:   22650 151st Avenue Box Elder, SD 57719


Contestant__________________________NWBRA #____________WPRA #____________

Horse's Registered Name(2) 1._____________________  c/o______  2.__________________________c/o_____
 
3.____________________________ c/o ____       4.____________________________c/o_____ 

Carry overs to Saturday night 4D from Futurity or Maturity MUST
be declared prior to first round.  Please note above if you are carrying your time.

Address____________________________________________________________

Phone______________________ Email_________________________

I (we) hereby make application to enter the above named horse in the 5-State Breeders Open 4D. I (we) agree that ALL 5-State Breeders Barrel Futurity/4D decisions are to be FINAL. I (we) hereby release the above 5-State Breeders Barrel Futurity, LI Productions, futurity co-sponsors, and the Central States Fairgrounds from any claim or loss to myself, rider, employee, horses and/or equipment. Signature______________________________________________________

FUTURE FORTUNES HORSES ONLY - one entry blank per Future Fortunes Horse Please

Rider's Name____________________ Owner_______________________Owner SSN _____________

Sire___________________ Dam___________________ Year Born__________

Owner Address____________________________________________________________

ALL FUTURE FORTUNES ENTRIES MUST INCLUDE FRONT AND BACK OF PAPERS
LATE ENTRIES MUST BRING PAPERS TO CHECK-IN
FUTURE FORTUNES CHECK-IN 4:00-4:30pm in warm-up area
(you MUST check in to be eligible for Future Fortunes Bonus Money)