Telephone (area code)***-**** * Manitoba Rodeo Cowboys Association Membership Application and Release Form (A Non-Profit Corporation Pursuant of Part II of the Canada Corporation Act) This form must be completed and on file with the Manitoba Rodeo Cowboys Association, and approved by the MRCA Board of Directors before a MRCA membership number and card will be issued.   First Name * Middle Name or Initial Last Name * Mailing Address * City * Province/State * Postal Code/ZIP * Email Address * Birthdate (Month/Day/Year) * Sex * MALE FEMALE Have you ever held an MRCA card before? * YES NO Have you ever held a Senior Card in any other Associations? * YES NO If Yes, Which Associations? Rookie Declaration: If you have never held a full senior card in an equivalent level of rodeo association, and are purchasing a senior card for the first time, this would be considered your rookie year. You may upgrade a Junior or Permit to Senior during the year, and declare your rookie status at that time. Are you declaring this as your rookie year? * YES NO   If you are not currently a CCA member, $18.00 insurance fee will be added to the cost of the membership   SENIOR~May compete at MRCA Approved rodeos $145.00 plus $7.25 GST = $152.25 PERMIT~May compete at MRCA Approved rodeos where permits accepted. $70.00 plus $3.50 GST = $73.50 JUNIOR~Contestant must be 18 years & under as of January 1st of current year $45.00 plus $2.25 GST = $47.25 PERSONNEL~Stock Contractors, Judges, Pick up Men, Bullfighters, Clowns & Announcers $120.00 plus $6.00 GST = $126.00 TIMERS~Must be qualified to work MRCA Approved rod $70.00 plus $3.50 GST = $73.50 ASSOCIATE~Non-contestant $70.00 plus $3.50 GST = $73.50 Membership You wish to Purchase * Senior - $145.00 + $7.25 GST Senior Non CCA Member - $145.00 + $7.25 GST + $18.00 Insurance Permit - $70.00 + $3.50 GST Permit Non CCA Member $70.00 + $3.50 GST + $18.00 Insurance Junior $45.00 + $2.25 GST Junior Non CCA Member $45.00 + $2.25 GST + $18.00 Insurance Personnel - $120.00 + $6.00 GST Personnel Non CCA Member $120.00 + $6.00 GST + $18.00 Insurance Timer - $70.00 + $3.50 GST Timer Non CCA Member $70.00 + $3.50 GST + $18.00 Insurance Associate $70.00 + $3.50 GST Associate Non CCA Member $70.00 + $3.50 GST + $18.00 Insurance Late Membership Surcharge $25.00 for those who are entered in a rodeo with another association card, or hometown, but would like their points to count. Must be purchased before you compete Late Membership Surcharge   A membership card will not be issued until a suitable head shot picture has been received by the office. You can upload a picture now, or send one by mail, or email to office@mrcarodeo.com Picture Upload   Disclaimer: By submitting this form and processing payment, you agree to abide by the rules and regulations as set out in the Manitoba Rodeo Cowboys Association Rule book. It is your responsibility as a member to know and understand the rules outlined. If you are under 18 years of age, you must have a parent or guardian present to submit this form.   Total Amount to be processed Security Code *