Izard County Fair & Livestock Show
Livestock Nomination Form
Purple Circle Championship Deadline -- Entry Form must be postmarked by July 15
(Any animal that may become eligible for a Purple Circle Championship must be nominated by July 15)

Exhibitor's Name:                                                                                                           4-H or FFA Club:
Address:                                                                                       City:                                          State:                                          Zip:
Jr. Exhibitor's Birthday:                                                                                              SSN:
Are you doing Showmanship?  (Please circle one)
YES                               NO
Species Breed Registered Name of Animal Registration # Animal
Date of Birth		 Date of Ownership Sex
             
             
             
             
             
             
             

Release and Waiver by Junior Exhibitor and Parent or Guardian

I, the undersigned, hereby release the management and board members of the Izard County Fair Association and their officers, members, agents, employees, or volunteers of and from all claims, demands, action or cause of action, of any nature whatsoever, whether known now or ascertained, or which may hereafter develop or accrue through me in favor of myself, my hires, representative, appointees, or dependents, on account of, or by reason of any injury, loss or damage, which may be suffered by me or them, or any of them, or any property, aminate or inaminate, belonging to me or used by me because of any manner, thing, or conditions, negligence or default, whatsoever and I hereby assume and accept the full risk and danger of any hurt, injury, or damage which may occur through or by any reason of any manner, thing or condition, negligence or default, or any person or persons whatever.

I have read and understand, and in consideration for being permitted to exhibit at this event, agree to abide by the rules of competition as stated in the guidelines for this event.


________________________________________________________________________________________________________________
Signature of Junior Exhibitor                                                                                                                                            Date

________________________________________________________________________________________________________________
Signature of Parent or Guardian                                                                                                                                        Date

________________________________________________________________________________________________________________
Signature of 4-H or FFA Club Advisor/County Extension Agent                                                                               Date

All exhibitors are asked to print, sign and return a Permission to Publish on the World Wide Web (Internet) Form.  Forms available on website.
Please print, complete and mail forms to:     Izard County Fair Board, Attn:  Mark Green, Box 220, Calico Rock, AR 72519