Ride Registration
Horseshoe Bend Boogie
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Rider is:
*
Junior (under 16)
Young Rider (16-21)
Senior (over 21)
If Rider is Junior, name of sponsor
Rider AERC #
*
Usually starts with M; if none, enter None
Rider SEDRA #
Leave blank if you're not a SEDRA member
Rider ECTRA #
Leave blank if you're not an ECTRA member
Rider RATA #
Leave blank if you're not a RATA member
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Horse and Event Information
Horse Name
*
Horse AERC #
*
Must begin with H
Coggins date
*
/
Month
/
Day
Year
Date
Coggins Accession Number
*
"I don't have it handy" isn't a good answer.
Event (includes Friday night camping)
*
Intro: $60
30-mile ride: $160
50-mile ride: $160
Ride and Tie (includes 2 riders): $180
AERC non-member fee
*
I'm a member: $0
I'm not an AERC member but am riding the intro or R&T: $0
I'm not an AERC member and am riding the LD or 50: $20
Extra meals (dinner on Friday night and continental breakfast)
*
None, it's just me: $0
1 extra: $12
2 extras: $24
3 extras: $36
Junior discount (must be 16 or younger)
*
Junior: $-50
Not a junior: $0
Late fee (only applicable if you pay on or after August 9)
*
Not applicable, I'm into making it easier on the RM and saving money!
Yes, I'm tardy and will pay for it (literally!): $50
Payment method
*
Will mail a check: $0
PayPal: $5
Comments for Ride Manager
If you are riding the R&T, please enter information about second rider here.
Total Amount Due
Submit
Should be Empty: