Entry Form
Rider Name:
   Horse Name:
  
AERC #:
   Horse AERC #:
  
Address:
   Breed:
  
City,
   Reg #:
  
State
   Color:
  
ZIP:
   Sex:
  
Phone:
   Age:
  
E-mail Address:
   Owner:
  
(Circle One)   First AERC Ride?  YES___       NO  ____            T-SHIRT SIZE    Sm__   Med__   Lg  __ X-Lg__   XX -Lg__
JUNIOR RIDER   YES ____        
Please check the box below the appropriate division        Weight with tack:
Featherweight
(up to 160 lbs)
 Lightweight
(161 – 185 lbs)
 Middleweight
(186 – 210 lbs)
 Heavyweight
(211 lbs & up)
       
Release – Contains limitations on liability – Please read and sign!
As a participant in a ride, I agree to abide by the rules of AERC, ECTRA, and Ride Management.
I understand that endurance riding involves being in remote areas for extended periods of time, far from
communications, transportation and medical facilities; that these areas have many natural and man-made hazards,
which ride management cannot anticipate, identify, modify or eliminate; that horses can be excitable, difficult to control,
and unpredictable; and that accidents can happen to anyone at any time. I agree to take full responsibility for myself
and the animal I am riding. I will hold the ride management, all ride personnel, Pennsylvania State University,
Pennsylvania  DNCR, and all property owners over whose land the ride crosses, blameless for any accident, injury or
loss that might occur due to my participation in the ride, and free from all liability for such injury or loss.
I have read and understand this liability release.

Rider’s Signature:                                                        Date:        
                                                                  
Parent/Guardian (junior rider):                                   Date:
                                                                  
Horse Owner’s Signature:                `                         Date:                                                                                                                
$25 OFF FOR
ALL JUNIOR
RIDERS
$50.00 off
the 100
 POST MARKED
ON OR BEFORE
5/12/08
 Entries After
5/12/08
 You may pay the full amount
now, or a $25 deposit and
the balance at registration
 SUBTOTAL
 Sat
May
24,
2008
 Sun.
May 25
2008
100 Miles
 $150
 $180
      
50 Miles &
 $90      
 $120
      
30 Miles R&T*
 $80
 $110
        
30 Miles
 $70
 $ 100
        
Extra Supper Fri.
Extra Supper Sat.
 $8.00    X  _____  meals=                                             
$ 10.00   x ______ meals =
      
AERC Day
Membership
 $15
      
Please make checks payable to: Skip Kemerer   Mail entry form to: Skip
Kemerer 12908 Brandenburg Hollow Road, Myersville Md. 21773                            
                                                 TOTAL:
      
Questions??     Call 301-293-2949                or        
         email    michauxmadness@yahoo.com           
                      
 Less $25 Deposit:              
      
* Per R&T Team   Includes 2 meals and T-shirts
                                                                                        Balance Due at registration:
      
2008 MichauxMadness 30/50/100 miles ENTRY FORM       Your Ride Distance:  Sat  30 __50 _       
                                                                                                                                         Sat. Ride & Tie  30___
Double click above to download the entry form in Word                                  Sun. Ride & Tie 30__
                                                                                                                                        Sun 30 __55__ 100_