Rider Information

Distance Select One Open 25 Open 25 Junior Open 50 Open 50 Junior Open 100 Open 100 Junior   Juniors are 8 - 16 years of age.

First Endurance Ride Select One No Yes

Name

Address

City     State         Zip

Phone       Email 

AERC#        SEDRA#   AHA#

Junior DOB   Sponsor

Weight Div Feather Light Middle Heavy - Select One -            T-Shirt Size

Horse Information

Horse

AERC#     SEDRA#   AHA#

 Breed    Age   Sex  Gelding Mare Stallion - Select One -

Color

Owner

Owners AERC#     SEDRA#     AHA#

Enter any additional information you would like us to know:

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