FEI

 

Yes    No

 

Arabian Nights Endurance Event

 

ENTRY FORM

 

Rider  Number

(management use)

 

Read and  sign the rider  release of liability!!

 

Rider:  AERC# _______   Name_________________________________________

 

Address: ____________________________________________________________

 

Phone: _________________   Email: _____________________________________

 

AERC Weight Division:    Feather         Light         Middle         Heavy           Junior

 

Horse:  AERC#_______   Age_____   Name________________________________

 

Horse Owner Name _____________________________

AERC Pre-Registration entries must be recieved by August 20!! Entries after August 20 will have an additional $20 Late Fee. Pre-Registration entries will be refunded in full if Ride Management is notified of cancellation by Aug 24. ) 
FEI Entries must also complete the FEI Entry Form and Release (separate forms)
All FEI Entries MUST be received by August 17

  • AERC 100 Mile Entry Fee: $140.00                                            ____________

  • AERC 50 Mile Entry Fee: $90.00                                                ____________

    • All AERC entries include:

    -         Thursday Night Wine & Cheese Social  (open to all)

    -         Friday Night Dinner (1 meal ticket)

    -         Ride Day: snacks and refreshments (open to all)

    -         Awards Breakfast (1 meal ticket)

  • Corral Pen (Thu - Mon, reservation needed): $20.00                  ____________
  • Extra Friday Dinner: $12.50 each                                                 ____________
  • Extra Sunday Breakfast: $7.00 each                                             ____________
  • FEI Entry Fee: $100 additional for CEI*** division                     ____________
  • FEI Entry Fee: $20 additional for CEI** division                     ____________
  • FEI Drug Test Fee (Mandatory for all FEI entries)        - $20.        ____________

    Total  ………….                                                                                 ____________

     

    Checks (payable to Steph Teeter) or Credit Card _____ _____ _____ _____  ___/___

     

    Mail or fax entry to:

    Steph Teeter

    15401 Bates Creek Rd

    Oreana, ID 83650

    fax: 209 755 8107

    For more info:

    steph@endurance.net

    phone: 208 834 2788

    www.endurance.net/oreana/arabiannights

     

     

     

     

    RELEASE For all Participants of the Arabian Nights Endurance Ride

     

     

    I, _________________________________________________________(print full name here), wish to enter and participate in the Arabian Nights Endurance Ride, to be held August 26-August 28, 2005 and I have read the rules, conditions, and regulations of the event and will comply with them.  As a participant in the event, I agree to abide by the rules of all sanctioning organizations, including AERC, US Equestrian Federation (USEF),  and the aforementioned ride.

          I agree that my participation in the ride involves certain inherent risks, which include, but are not limited to, the following: (1) horseback riding involves being in remote areas for extended periods of time, far from communications, transportation, and medical facilities, that these areas can have many natural and man-made hazards which ride management cannot anticipate, identify, modify, or eliminate, these hazardous surfaces/subsurface conditions including such things as rocks, trees, puddles, streams, fences, jumps and/or other hard objects and /or holes, divots, ledges which could cause an equine to trip and /or fall and /or could strike a participant who falls from or is thrown from an equine; (2) that horses can behave in unpredictable ways which can result in accidents to anyone at any time, resulting in injury, severe injury, or death; (3) that an equine's reactions to sound, movements, objects, vehicles, persons, animals, scents, or insects cannot be predicted.  I agree to take full responsibility for myself/my child or children, and the animal(s) I/my child or children is/are riding or have in camp.  I will hold harmless the AERC and the USEF, its officers and all individual members there of, Bureau of Land Management-USDI, employees of such, John and Steph Teeter, all ride personnel, and all property owners over whose land the ride crosses, their representatives, successors and assigns, for any accident, injury or loss that might occur due to my participation in this ride, and free all liability for such injury or loss, including that due to negligence not caused by wanton or willful misconduct of the Arabian Nights organizers and management.

    I hereby certify that my horse is not under the influence of medication and will not be treated with or given any medications prohibited by AERC rules.  I also hereby give permission to AERC or its duly appointed agent to take any appropriate action deemed necessary to check for possible administration of drugs to my hose.  The undersigned verifies acceptance of risks and responsibilities for rider's and horses' conditions and certifies that all information on this form is correct to the best of his/her knowledge.

     

    Rider __________________________________________________

     

    Horse Owner ____________________________________________

     

    Parent/Guardian of under 18 Rider _______________________________

     

    Date: ____/____, 2005