AERC # (enter N/A if no number)
AERC # (enter N/A if no number)
AERC # (enter N/A if no number)
AERC # (enter N/A if no number)
First Name
Last Name
AERC Weight Division
Please Select
Please Select A Division
Feather (160/below)
Light (161-185)
Middle (186-210)
Heavy (211/up)
Sponsored Junior
FEI/USEF Division
Please Select
Please Select A Division
Senior
Young Rider
Rider's Address
City
State
ZIP
Phone
If non-US Rider give Nationality
Email
Shirt Size
Please Select
Please Select a Size
Sm
Med
Lg
Ex Lg
Jr. Sponsor's Name
Jr Riding As adult?
checkbox
Jr. Sponsor's Name
Jr. Sponsor's Address
Emergency Contact (At home)
Contact Phone Number
Horse AERC#
Please Select
Not Riding
50 Mile - $100
FEI/USEF 50 Mile - $200
75 Mile - $150
FEI/USEF 75 Mile -$250
Horse AERC#
Horse AERC#
Horse AERC#
AERC # (enter N/A if no number)
Horse Name
Breed
Year Horse was Born
Gender
Please Select
Choose
G
M
S
Color
Owner Name
Owner Name
Owner Name
Owner Name
AERC
Please Select
0
$15.00
FEI HIP and Drug
Please Select
0
$63.00
Horse AERC#
Please Select
Not Riding
25 Mile LD - $85
55 Mile - $100
FEI/USEF 55 Mile - $200
75 Mile - $150
FEI/USEF 75 Mile - $250
100 Mile Ride - $250
FEI?USEF Ride - $350
Horse AERC#
Horse AERC#
Horse AERC#
AERC # (enter N/A if no number)
Horse Name
Breed
Year Horse was Born
Horse Name
Please Select
Choose
G
M
S
Color
Owner Name
Owner Name
Owner Name
Owner Name
AERC
Please Select
0
$15.00
FEI HIP and Drug
Please Select
0
$63.00
Event_3
Please Select
Not Riding
25 Mile LD - $85
50 Mile - $100
FEI/USEF 50 Mile - $200
Horse AERC#
Horse AERC#
Horse AERC#
AERC # (enter N/A if no number)
Horse Name
Breed
Year Horse was Born
Gender
Please Select
Choose
G
M
S
Color
Owner Name
Owner Name
Owner Name
Owner Name
Non-Member Fee ($15)/ride
Please Select
0
$15.00
FEI HIP and Drug
Please Select
0
$63.00
AERC # (enter N/A if no number)
Please Select
N/A
$40.00
Subtotal_Rides
Ground Fees $10 per Horse per Day:
Ground Fees $10 per Horse per Day:
Ground Fees $10 per Horse per Day:
AERC # (enter N/A if no number)
Number Tickets:
Click box for total dinner fees:
Number Tickets:
TOTAL AMOUNT ENCLOSED:
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