Number of Employed Operators
Full Time:
Part Time:
Annual Payroll:
Names of all operators:
If independent contractors are ever used to operate, est. annual costs for such labor $
Operation of Bull(s) is: Fixed
Mobile
Provide complete address:
List ALL states where operation anticipated:
Physical Description of Bull(s)
How many mechanical bulls do you own:
Select #
1 2 3 4
Manufacturers Name, City, State, Country:
Serial #:
Years Made:
Manufacturers Name, City, State, Country:
Serial #:
Years Made:
Manufacturers Name, City, State, Country:
Serial #:
Years Made:
Manufacturers Name, City, State, Country:
Serial #:
Years Made:
If Galaxy bull, what model is it? Regular
Deluxe Both
Is bull electric? Yes
No
Does each device have an emergency shut off? Yes
No
Is each device equipped with variable speed controls? Yes
No
Does the device have soft horns? Yes
No
Does the device have a padded head? Yes
No
Years in business:
# of Bulls Owned:
Annual Gross Revenue:
Minimum Fenced Radius of 10 feet or more? Yes
No
Does device have enclosed inflatable arena with a min. 16 inch inflatable landing? Yes
No
Minimum ceiling / overhead clearance of 12 feet or more? Yes
No
Base of unit completely covered with padding? Yes
No
Is alcohol served by the venue where the mechanical bull is present? Yes
No
Do mechanical bull operators monitor for patron alcohol use? Yes
No
NOTE: Remember not to hit your back button or your refresh button so that you do not
accidentally erase or wipe out any type of information that you have typed in.
Month / Year of last inspection by a certified / independent inspector?
Do operators have test procedures provided by the manufacturer to: Determine if ride is operating
within mfr’s prescribed limits?
Yes
No
Evaluate product wear?
Yes
No
Do operators have mfr’s manual describing proper operation / schedules of routine inspections required
/ required maintenance?
Yes
No
Are all ride operators at least 19 years of age?
Yes
No
Number of operators supervising use of the unit at any one time?
Are operators trained to strictly enforce all rules / regulations even if it means stopping a ride early
or refusing a ride to a customer?
Yes
No
What is the minimum age requirement you mandate for any rider?
Are warnings transmitted to prospective riders in advance by way of conspicuously posted signs or
otherwise (preferably bilingual in English / Spanish) as pertains to:
a. Participants are required to sign waiver of liability before participating in any rides.
Yes
No
b. No one under the age of 18 can ride without the presence of their parent or legal guardian, and
such parent or legal guardian are required to sign waiver of liability for that rider.
Yes
No
c. Rider is participating at their own risk, and neither ride owner nor operator is responsible for accident
or injury to any person arising out of the mechanical bull ride.
Yes
No
d. Individuals with pre-existing conditions such as back, neck, leg, or arm injuries are not permitted
to ride. However, ride operator is not responsible for determining the physical condition or ability of
any rider.
Yes
No
e. Participants may request that the ride be stopped at any time.
Yes
No
Does operator check photo ID to verify participant is same individual and age?
Yes
No
Are Waivers signed in the presence of the operator or other attending employee?
Yes
No
How long are signed waivers retained?
Where stored?
Does operator verbally ask about pre-existing injuries, and if any, refuse the ride?
Yes
No
Are your operators instructed to require riders under the age of 18 to wear helmets?
Yes
No
Note: This application MUST include a copy of the Waiver of Liability / Rider Release form used.
Such form MUST include a hold harmless agreement in favor of both ride owner and operator as
well as outline all terms and conditions the participant agrees to follow. Bilingual language is preferred
(English/Spanish).
Attach Waiver of Liability / Rider Release
NOTE: Remember not to hit your back button or your refresh button so that you do not
accidentally erase or wipe out any type of information that you have typed in.
Do you ever allow free rides?
Yes
No
If yes, explain under what circumstances and approximate number per year:
Prior General Liability Insurance Company:
Expiration Date:
Premium:
Describe all claims arising out of your mechanical bull units for the past 4 years:
Provide a diagram of the operational area to include placement of bull, area of padding, location of
fencing or other barriers, distances to spectator area, walls or any other obstructions.
Attach Diagram: