Australian Endurance Riders Association Inc

TEERA Inc. ENDURANCE HORSE LOGBOOK APPLICATION page 1 of 3

HORSE DETAILS Name * Reg. No. Sire Reg. No. Dam Reg. No. Microchip No. Sex Date of Birth Breed Colour Height * Please specify the horse’s registered name and forward a copy of the breed registration certificate.

OWNER/AGENT DETAILS (must be a member or the logbook will not be issued) Owner/Agent Name Post Code Address Telephone No. Email Membership No. I certify that the information Signature Date provided on this form is true and correct: ENDURANCE HORSE LOGBOOK FEES

If the ID has not already been completed by an accredited veterinarian, you will be required to have an ID page completed. A Microchip, if required, will be supplied to you. Disposable implanters are available if required. Once the ID Form has been completed by an accredited Veterinarian and, if required, the Microchip has been inserted please return this form, payment, the ID form, together with the Novice Horse Log book/s containing at least 240 kms of successfully completed affiliated endurance rides.

Please Note: An endurance horse log book will not be issued until 90 days from the date of the first affiliated endurance ride that the horse successfully completes.

Endurance Horse Registration Fee 1 Year $25.00 □ Lifetime $60.00 □ Novice 2-in-1 Logbook Upgrade to Open $ 5.00 □ Replacement Logbook Fee $30.00 □ Microchip Fee (if not already chipped) $20.00 □ Log Book Covers [ ] @ $ 2.50 □

OFFICE USE ONLY PLEASE MAKE ALL CHEQUES / MONEY ORDERS Receipt No. PAYABLE TO: “TEERA Inc.” Microchip No. Log Book Serial No. Send payment and supporting documentation to: Horse No. TEERA Log Book Registrar Date Issued For current contact and address details please Date Qualified Refer to the the website: Qualifying Ride www.aera.asn.au/teera/forms.htm Registration TEERA Inc. ENDURANCE HORSE LOGBOOK APPLICATION page 2 of 3

Horse identification markings (to be completed by a registered veterinarian) Horse Name Head and neck

Left fore

Right fore

Left hind

Right hind

Brands and acquired marks Microchip No. Show the placement of all identification markings on the diagram below

Certification by registered veterinarian Signature: I am a registered Veterinarian and I certify the information I have entered on this document is true and Name: correct. Date: TEERA Inc. ENDURANCE HORSE LOGBOOK APPLICATION page 3 of 3

AUSTRALIAN ENDURANCE RIDERS ASSOCIATION INC

APPLICATION FOR REGISTRATION OF A CURRENT QUALIFIED ENDURANCE HORSE

As from 1st January 2004 the AERA have implemented a registration system for all qualified endurance horses. This will be a lifetime fee of $60 or a yearly fee of $25 per horse per year, payable when the horse is qualified and intends to compete using a yellow log book. A label will be placed inside the front cover of the log book. Rule H6.4 An endurance horse can only enter an affiliated endurance ride if it has a current registration label in its log book.

To apply for your labels, please complete the following details and forward with your payment to the TEERA Log Book Registrar. For current contact and address details see the website: www.aera.asn.au/teera/forms.htm

Owners Name: ______

Address: ______Postcode: ______

Membership Number: ______Date: ______

Name of Horse AERA No. Fee ($60 or $25 per horse)

To assist in maintaining our records, please advise of any horse that has a yellow log book that is no longer competing for any reason.

Name of Horse AERA No. Reason