Horseshoe Bend Boogie Registration

Ride Registration

Horseshoe Bend Boogie
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.
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