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Accredited Member of the
North American Riding
for the Handicapped Association

Lift Me Up! 2009 Benefit Ride Online Pre-Registration
Saturday, May 23, 2009 at Rolling Meadows Farm in Loudon County, VA

  • Riding Helmets are required
  • Current Negative Coggins Test is required
  • Participants under 16 years of age must be accompanied by an adult

Riders may start any time between 10:00 AM and 12:00 PM. Within that time frame, riders may start at any time and ride at their own pace. The trail includes some rocky areas, steep hills, gravel roads, and creek crossings. Depth of water will vary depending on recent rainfall.

Pre-Registration Please fill out the form for each rider - do not combine registrations.
Rider's Name:
Street Address:
City:
 State: Zip:
Phone#:
Email Address:
Emergency Contact Name:
Emergency Contact Phone#:
Horse's Name:
I will be riding with:
I will be carrying a cell phone. The number is:
Parent/Guardian Name:
Parent/Guardian Address:
Parent/Guardian Phone#:
Notes:

 


Lift Me Up!
PO Box 104
Great Falls, Virginia 22066
Phone: 703-759-6221
Email: info@liftmeup.org