MEMBERSHIP FORM

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Date of Birth

Phone

(###)

###

####

Gender

MALE

FEMALE

Which option best suites you? ( See Table to the right )

#1

#2

#3

#4

#5

#6

Please rate your roping talent (1-6)

FOR NEW MEMBERS ONLY

Please rate your horses experience from ( 1-6 )

FOR NEW MEMBERS ONLY

How many years have you competed in Breakaway or Team Roping? ( please specify )

FOR NEW MEMBERS ONLY

How much money have you won in Breakaway or other Equine Events? ( Please specify discipline or event )

FOR NEW MEMBERS ONLY

Do you currently or have you held a WPRA pro card? If yes, When?

FOR NEW MEMBERS ONLY

What are your consistent catch times?

FOR NEW MEMBERS ONLY

Please fill out the form below to become a Member with Cinch Breakaway Roping Championships. Memberships are valid through the 2026 Finale
Cinch BRC Memberships will be available for purchase at Cinch BRC events, online at cinchbreakaway.com, or by email info@cinchbreakaway.com.

Download Membership Form here

Download classification handout