NASS 2021 Distance National Championship Ride
Proudly held in conjunction with the Mary and Anna Memorial Ride La Pine, OR | Saturday, Aug 28, 2021
Pre-Registration, Pre-Qualification and Payment Due Aug 3, 2021
25/50 = $50, 75/100 = $100, Fees in addition to Ride Entry Fees via PayPal: treasurer@shagya.net
Pre-Qualification Requirements For Horse and Rider
25 Mile Distance Pre-Qualifications
2 AERC lifetime completions of any of: 25/30, 50, 75, or 100 rides
50 Mile Distance Pre-Qualifications
2 AERC lifetime completions of any of: 50, 75, or 100 rides
75 and 100 Mile Distance Pre-Qualifications
4 AERC lifetime completion of any of: 50, 75, or 100 rides
Rider Name
First Name
Last Name
Rider Email
example@example.com
Which Distance Are You Riding?
25
50
75
100
Rider AERC Info
Rider AERC Number
Rider Lifetime AERC Miles
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Rider Phone Number
Please enter a valid phone number.
Horse Name
Horse Name
Horse Breed
Horse Registration Info
Registry: NASS, PShR, or ASAV
Registration Number
Attach Copy of Horse Registration
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Horse AERC Info
Horse AERC Number
Horse Lifetime AERC Miles
Horse Info
Color
Sex
Horse Info
Horse Owner
Horse Owner's Phone Number
Liability Release
As a participant in the Ride, I agree to abide by the Rules of AERC, PNER and the aforementioned ride. I understand that endurance riding involves being in remote areas for extended periods of time, far from communications, transportation, and medical facilities; that these areas have many natural and man-made hazards which ride management cannot anticipate, identify, modify, or eliminate; that horses can be excitable, difficult to control, and unpredictable; and that accidents can happen to anyone at any time. I agree to take full responsibility for myself and the animal I am riding. In exchange for the privilege of participating in AERC endorsed distance rides, I, my heirs, executors, and administrators will hold harmless and blameless AERC, PNER, NASS and all officers and directors thereof, all members of the ride management and ride personnel, all NASS personnel, and all property owners/tenants upon whose land the distance rides are held from all liability for any injury or loss to myself or my horse which occurs due to my participation, or anyone who accompanies me to AERC events. Junior riders shall abide by AERC and PNER rules of the ride, riding with a sponsor as required. Parent/Guardian signature gives permission for emergency medical treatment for Junior. I HAVE READ AERC AND PNER RULES, CONDITIONS, REGULATIONS AND REQUIREMENTS OF THIS RIDE AND WILL ABIDE BY THEM.
Signature
Please send payment via PayPal (www.paypal.com) to treasurer@shagya.net.
Submit
Should be Empty: