Please submit this form within 14 days of the completion of the event. Note: If you are to receive a stipend from Ride & Tie, return this form even if you do not owe any money to Ride & Tie. Late submissions will nullify your stipend.
THE FOLLOWING IS AN AGREEMENT BETWEEN THE MANAGEMENT OF THE FOLLOWING EVENT AND THE RIDE & TIE ASSOCIATION:
Ride Name (required)
Ride Date(s) (required)
Ride Manager (required)
Ride Manager Phone (required)
Ride Manager Email (required)
Stipend: Ride & Tie offered me a stipend and I complied with all requirements. Initial here:
Check all that apply: $200 for hosting, promoting and having R&T/Equathon participants compete
$100 for hosting and promoting a R&T/Equathon for the FIRST time at this event
Submission of results, membership forms/fees, financial summary and insurance fees (no more than 14 days after the date of this event)
Pay stipend to: (insert full name and/or organization)
Mailing address:
City:
State:
Zip Code:
Phone number: (if different from Ride Manager's)
Insurance Fees Number of teams 1st ride day: x $10 = (daily maximum $100)
Number of teams 2nd ride day: x $10 = (daily maximum $100)
Number of teams 3rd ride day: x $10 = (daily maximum $100)
Ride and Tie Membership Fees Individual Memberships: Adult Member x $35 =
Junior Member (Only valid from January 1, 2025 through November 30, 2027) x $15 =
Family Memberships: x $50 =
One Day Memberships: Adult Member x $15 =
Junior Member (Only valid from January 1, 2025 through November 30, 2027) x $5 =
Upgrading to Family (from current Annual Adult membership): x $15 =
Additional Donations or Other Income Please give contact info for donations or explanation for other income:
GRAND TOTAL ENCLOSED
Mail check to: The Ride & Tie Association – Treasurer, 4710 Kingsway, Anacortes, WA 98221-3210 Mail membership forms to: The Ride & Tie Association – Membership, 6746 Back Road, Maurertown, VA 22644, email scanned copies to membership@rideandtie.org or or submit online at https://www.rideandtie.org/electronic-membership.
Submit results to: Bob Heltibridle, bobheltibridle@gmail.com or via online entry at https://www.rideandtie.org/ride-results.