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KENLYN ARABIANS * RIDE ENTRY
FORM KENLYN FLAT (URBAN CHALLENGE 25/50 & 15 MILE ROOKIE RIDE) APRIL 24 & OCTOBER 2, 2010 |
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| Rider Name: | Rider AERC#: | ||
| Sponsor Name if under 16: |
Rider Age: | ||
| Address: | Emergency Contact Name & Phone#: |
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| Phone# & Email: | |||
| Horse Info | |||
| Horse Name: | Horse Age: | ||
| Horse Breed: | Horse Sex (G,S,M): | ||
| Horse Color: | Horse AERC#: | ||
| Horse Owner | |||
| Horse Owner Name & Address: |
Horse Owner AERC#: | ||
| Event | Check Box of the event you are entering and corresponding divisions | ||
| 50 Mile Endurance Ride Division: | Fees | ||
| Jr (under 16 as of Dec 1) | Entry: $95 | ||
| FWT (under 160 lbs) | Non-AERC: $15 | ||
| LWT (161-185 lbs) | |||
| MWT (186-210 lbs) | Extra Meal: $5 | ||
| HWT (211 + lbs) | Total Balance: | ||
| 1st Time Rider | |||
| 25 Mile Endurance Ride Division: | Fees | ||
| Jr | Entry: $95 | ||
| Adult | Non-AERC: $15 | ||
| 1st Time Rider | |||
| Extra Meal: $5 | |||
| Total Balance: | |||
| 15 Mile Fun Ride Division: | Fees | ||
| Jr | Entry: $45 | ||
| Adult | Extra Meal: $5 | ||
| 1st Time Rider | Total Balance: | ||
Liability Waivers: I wish to ride in the American Endurance Ride Conference (AERC) ride as listed above. I agree to abide the rules of the AERC and the aforementioned ride. I understand that this may involve being in remote areas for extended periods of time, far from communications, transportation, shelter, water and medical facilities; that these areas have many natural and man-made hazards, which ride management cannot anticipate, identify, modify or eliminate; that the horses can be excitable, difficult to control and upredictable; and that accidents can happen to anyone at anytime. I agree to take full responsibility for myself and the animal I may be riding, and hereby freely assume the risk of any injury or mortality suffered by the aforementioned animals as a result of my participation. The undersigned does for himself, his heirs, executors, and administrators, waive and release any person or persons connected with the aforementioned rides, individually and collectively, including but not limited: KENLYN ARABIANS STABLES, KEN FISHER, LINDA FISHER, CITY OF AURORA, COLORADO, MOUNTAIN REGION ENDURANCE RIDERS, and the AMERICAN ENDURANCE RIDE CONFERENCE and its officers and all individual members thereof, ride management, ride personnel, veterinarians, sponsors and all property owners over whos land the ride corsses, blameless for any accident, any right to assert claims for personal or property damage against any persons connected with the aforementioned ride. This ride entry form supersedes any forms previously published. I have read, understood and agree to the terms of the liability waiver for this ride. |
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Rider: ____________________________________________________ Date: ______________ Horse Owner: ______________________________________________ Date: ______________ Jr. Rider Parent/Guardian: ____________________________________ Date: ______________ Fill and print out, sign, make checks payable & send to: Kenlyn Arabians 1000 Salida Street | Aurora, CO 80011 Phone #303-364-9556 | Fax #303-366-7454 | Cell #303-807-0062 |
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