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2009 Membership Registration

2009 Membership Registration
Membership year is December 1 - November 30

Date: Please check one. NEW To Renew click here Endurance News Subscription Only
(subscription included with Full, Vet, and Junior Only memberships) Yes No

Primary Member:

Membership Level: Weight Div.:
(measured with full tack) Junior:
(Under 16 years old on Dec. 1, 2004) Veterinarian:
Are you a Vet?

Last Name: First Name: AERC#:

Birth Date: Month Day Year:

Address: Address2: Region:

City: State: Country: Zip/Mail Code

Home Phone: Work Phone: E-Mail:

Additional Family Members:
(a family is defined as two adults and any children born on or after 12/1/84 living at the same address)

Last Name: First Name: AERC#:

Birth Date: Weight Div.:
(measured with full tack) Junior:
(Under 16 years old on Dec. 1, 2004)

Relationship to Primary Member:

Last Name: First Name: AERC#:

Birth Date: Weight Div.:
(measured with full tack) Junior:
(Under 16 years old on Dec. 1, 2004)

Relationship to Primary Member:

Last Name: First Name: AERC#:

Birth Date: Weight Div.:
(measured with full tack) Junior:
(Under 16 years old on Dec. 1, 2004)

Relationship to Primary Member:

FEES: Enter Total $ Amount in each box

New Member: (includes Endurance News ) @ $65.00 each

New Member's Family @ $10.00 each

Junior Only Member: (includes Endurance News) @ $35.00 each

Veterinary Only Member: (includes Endurance News) @ $20.00 each

International Address (including Canada) @ $20.00 each

Number of International Members @ $10.00 each

Equine Registration(s) (after 1st horse) @ $10.00 each

Endurance News Subscription Only (12 Issues) @ $40.00 each

Trails Preservation Donation Optional

Other Please explain below.

Total Payment: (U.S. Funds only) This line is the $ total of the items selected above

Payment Information - Credit Card payment only - please pay online via the secure link provided on the next page

It will take a minimum of 10 business days for the office to process your membership and mail your card to you. To call or fax AERC -

Tel. (530)823-2260
fax (530)823-78705
Toll Free (866)271-AERC To e-mail AERC -

aerc@foothill.net

Registry Information

Horse # 1

Horse's Name Horse's Nickname: Foaling Date Gender

Color Breed Breed Registry Registry ID#

Horse # 1 Change of Ownership

Owner's Name Former Owner: Owner's AERC #: Region:

Horse # 2

Horse's Name Horse's Nickname: Foaling Date Gender

Color Breed Breed Registry Registry ID#

Horse # 2 Change of Ownership

Owner's Name Former Owner: Owner's AERC #: Region:

Phone: 530.823.2260
Toll Free Number: 866-271-AERC
Fax: 530.823.7805
Email: aerc@foothill.net

Mailing address:
AERC
P.O. Box 6027
Auburn, CA 95604

Visit us at:
1373 Lincoln Way, Suite B
(diagonal from the historic Auburn Courthouse)
Auburn, CA 95603

Kathleen Henkel
AERC Executive Director
Email: kathleen@foothill.net

AERC Staff

Suzi Souza - Finance - Email: aercaccounting@foothill.net
Judy Hall - Records Coordinator - Email: judyhall@foothill.net
Troy Smith - Publications - Email: endurancenews@foothill.net

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