Mary & Anna Memorial Ride

Mary & Anna Memorial Ride ~ EDRA

August 30, 2020 ~ EDRA Endorsed
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number to contact before ride *

Area Code Phone Number
Cell Phone to contact during ride *

Area Code Phone Number
Emergency Contact during ride *

First Name Last Name
Phone Number for Emergency Contact *

Area Code Phone Number
Rider EDRA Number:
Rider PNER Number:
Horse Name: *
Horse EDRA Number:
Horse PNER Number:
EDRA Weight Division: Weight includes rider and tack: *

I (up to 170 lbs) II (171-200 lbs) III (201+ lbs) Youth Rider (17 years and younger as of January 1, of the year in which they are riding) None--Volunteer only
What distance will you be riding? (Check all that apply): *

Trail/Intro Ride - $35 25 Miles - $100 50 Miles - $115 75 Miles - $135 100 Miles - $175 Youth Rider (Age 18 & under) All entry fees for youth riders are free. 50 Mile TYM Relay - $230 for two riders--enter name of other rider below None--Volunteer only
What level of camping amenities do you prefer? (Hookups and pens are all claimed--sorry!)

Self-Contained, no Horse Pen None needed, driving in/out same day
Discounts:

50% Reciprocal Ride Manager Discount (All ride managers are eligible!)
Payment

Please add up ride fee(s), apply discount if applicable, then add meal fee(s). Camping will be paid separately, probably at the ride (bring at least one blank check!) so we only collect payment for the level of amenities you ultimately get. Submit via the PayPal button below, or if you prefer, log in to PayPal directly, then send payment to dmmerlich@gmail.com ,with a note of your name so we can match payment to registration. Thank you, and see you there!
Payment Amount

prev next ( X )
USD Total Ride Fee(s) and Meal(s)

loading smart payment buttons...

The payment is ready! It will be completed once you submit the form.
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Mary & Anna Memorial Ride ~ EDRA