2023 TERA Membership

Form
Texas Endurance Riders Association

2023 Membership Application and Renewal
NAME: First Name* Last Name*
TERA Number: Number AERC Number: Type a label
Renewing only? If everything is the same as last year, simply fill out your name, TERA and AERC numbers above, birthdate and email below and submit. Use the Paypal button on the webpage to pay for your Membership.
Address

Street Address

Street Address Line 2

City State

Zip Code
Date of Birth*

MonthDay Year
Date
Email*
example@example.com
If you are registering as a family, please indicate first and last names of your spouse and the names & ages of minor family members:

First Name Last Name Date of Birth TERA # AERC #
First Name Last Name Date of Birth TERA # AERC #
First Name Last Name Date of Birth TERA # AERC #
First Name Last Name Date of Birth TERA # AERC #
First Name Last Name Date of Birth TERA # AERC #
Choose Membership type:

Single - $26.50Family - 36.75
Should be Empty:

Form