The California Range Riders present

"Gold Dust Fever IV"

September 24-25th, 2005

Santa Clara County Horsemen’s Arena, San Jose/Almaden

A CMSA Double WPQ Mounted Shooting Match

Rider ________________________________________________ CMSA # _______________

alias: ________________________________________________ div/level ___________________

address: ______________________________________________________________________

phone: _______________________ email: ____________________________________________________

CMSA Main match fee X the number of riders _____________ @ $120.00 ____________

3 Opt Jackpot stages, 2 drawn, X the number of riders _______ @ $30.00 ____________

Mntd RIFLE, match ammo, X the number of riders _________ @ $25.00 ____________

TIME only, match ammo, X the number of riders ___________ @ $60.00 ___________

Wranglers X the number of riders ________________________ @ $35.00 ____________

Horse Camping ______________$5 per horse per night X number of horses ____________

Will you join the CRR today? @ $25.00 single / $40.00 fam / $20 assoc. member $ ________

Will you be joining CMSA today? @ $50.00 single / $80.00 family membership $ _________

CRR Member $10 discount _______ CRR Associate Member $5 discount -- $ _________

Paid by cash: $ _____________ Check: $ ___________ TOTAL: $ ______________

Ammo received ____________ Signed Release of Liability form___________________

T-Shirt received (opt)_______ Costume Contest (Opt) ___________________

Oldbuckaroo7@aol.com 408-710-1616 (CRR) California Range Riders

Save time at signups:

print yourself a copy of this form and bring it to the match

Make checks payable to: CRR ( Dogs must be kept on a leash)