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Clinic Registration

Please use the form below to register or print and mail this pdf file
 

Name: 

Address: 

City: 

State & Zip: 

Phone: 

        Ext.

E-mail: 

Clinic Date: 

I would like to audit a clinic: 

 

I would like to ride in a clinic: 

 

If you wish to ride in a clinic please provide the following information:

Horse’s Name: 

 Breed of Horse: 

 Horse’s Age: 

Briefly describe any previous training your horse has experienced and that you have experienced:

Are there specific issues that you need help solving with your horse?
If so please briefly describe:

If you have any additional comments or questions add them here:

 

 

 

 

Please enter this security number ( 238 ) and click [Send]: 

 

 

 

 

 

 

 

 

 

 

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