Personal Information
Rider's Name:		AERC #
Address:		City:
State:		Zip:
Main Phone:		Cell Phone:
Email:		Rider's Age:
Horse #1
#1 Horse Name:		Breed/Reg #
AERC #		Horse's Age:
Sex:		Color:
Ride Days: (check)	1    2     3	Owner's Name:
Owner's Address:
Horse #2
#2 Horse Name:		Breed/Reg #
AERC #		Horse's Age:
Sex:		Color:
Ride Days: (check)	1    2     3	Owner's Name:
Owner's Address:

Riding Day/Fee	Weight Division
55 Mile 1st Day – $90	Heavy (211+ lbs.)
25 Mile 1st Day – $80	Middle (186–210 lbs.)
50 Mile 2nd Day – $90	Light (161–185 lbs.)
25 Mile 2nd Day – $80	Feather (0-160 lbs.)
50 Mile 3rd Day – $90
25 Mile 3rd Day – $80
Are you an AERC Member?   Yes   No
(Per Day Fee for Non-AERC Members – $15/Day)
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REGISTRATION FORM