ONLINE RIDE NOMINATION FORM - NO PRE-PAYMENT REQUIRED
NOMINATION FORM
Please complete all fields before submitting your nomination. Thankyou for your nomination.
RIDE DETAILS
Ride Name:
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FEB 06-07 Murrumba Seminar 40/20km
Ride Distance:
select distance >>
20km
40km
80km
120km
160km
Marathon
NOMINATION DETAILS
RIDER DETAILS
Rider Name:
Member Number:
Rider Status:
Open
Novice
Day Member
Under 18
Residential Address:
Email:
Phone:
HORSE DETAILS
Horse Name:
AERA Number:
Horse Status:
Open
Novice
Day Card
Date of last open ride completed:
Horse DOB:
Horse Breed:
Horse Details:
Gelding
Stallion
Mare
Division:
Heavyweight
Middleweight
Lightweight
Junior
Comments:
Please include any additional camping requirements etc
RIDER DECLARATION:
I hereby agree to abide by all current Australian Endurance Riders Association riding rules, training ride rules, procedures for rides, vetting procedures and Queensland Endurance Riders Association Inc organisers rule procedures, and to conduct myself in a manner not to be injurious or prejudicial to the character or the interests of the sport of endurance riding. In consideration of the ride organising committee accepting this entry, I hereby for myself, heirs, executors, administrators, waive and release the ride organisation committee and all persons or organisations associated with the ride, their representatives, heirs, executors, administrators and assign from any rights, claims, or liabilities for damages for injuries sustained by/to me, my support team or my animals.
Acceptance of Declaration
Full name of responsible member (over 18) completing this form: