International Lineman's Rodeo & Expo | Team/Apprentice Registration

Coordinator

Employer:

First Name of Rodeo Coordinator at company (if any):

Last Name of Rodeo Coordinator at company (if any):

Mailing Address:

Phone:

Fax:

Email:

All Rodeo information will be sent to the coordinator unless otherwise requested.

Division: (Please mark the appropriate division for your company or forms will not be processed)

IOU

Municipal

Contractor

REA

Military

Our companies competitors will compete with Fall Restraint devices on?

Yes

Apprentices

Apprentice Registration Form (pdf)

Apprentice registration fee: $125
(registration fee includes ticket to banquet, hat, t-shirt and registration materials)

First Name:

Last Name:

Title:

Phone:

Email:

Mailing Address:

Select Long Sleeve T-Shirt Size:

Journeyman Teams

Journeyman Registration Form (pdf)

Journeyman Team registration fee: $400/team
(registration fee includes ticket to banquet, hat, t-shirt and registration materials for all 3 team members)

Journeyman #1

First Name:

Last Name:

Title:

Phone:

Email:

Mailing Address: Street:

Select Long Sleeve T-Shirt Size:

Journeyman #2

First Name:

Last Name:

Title:

Phone:

Email:

Mailing Address:

Circle Long Sleeve T-Shirt Size:

Groundman

Name:

Last Name:

Title:

Phone:

Email:

Mailing Address:

Circle Long Sleeve T-Shirt Size:

If this is a Senior Team, check this box please.

Payment

Credit Card Type:

Card #:

Expires:

Confirm

Enter Code:

Participants are responsible for their own transportation, hotel, and meal expenses en route and during the Rodeo. Participants will be required to sign a
liability release before participating in the Rodeo, releasing the ILRA, any sponsors and their employer from any liability should an injury occur during the Rodeo.
If you have any questions, please call (913) 967-1865, or fax (913) 514-6865.
Cancellation policy: Refunds received in writing on or before Sept.23, 2013 will be given a 100% refund. No entry fee refunds will be given after that date.