Rushmount's Clinic Series

Clinician's Name *
Clinicians: *
  Krista Pollack  
  Despooking one Day 
  Hyde Moffatt 
 Polo Clinic 
  Trick Riding Clinic 
 Hyde Moffatt 
 Greg Kuti - March 24th 
 Sherri Whitworth Clinic 
Your selection will be tentative, as we will do our best to fit groups accordingly. There may or may not be a lunch break. Riding times will be announced by phone, email or posted on line 24 hrs prior to the clinic.
Rider Name *
Horse Name:
Stable / Trainer
Email *
Phone Number *

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Address:
Individual Auditor:
The First and last name of the person coming with you to the clinic.
One person may come with the rider free of auditing cost. This person must be named on the registration form to avoid auditing fees. EVERYONE else will be required to pay an auditing fee of $20 per person taxes included. This will include auditing and lunch. Thank you for your cooperation. Please contact Heidi to confirm the order of jumping heights and riding times as they are subject to change.
I would like to be put on
your next clinics email list.
 Yes 
 No 

Please check which discipline you
wish to train in. Also check one of the following Times/Heights that you
wish to participate in.

Discipline:
 Hunter 
 Jumper 
 Dressage 
One person may come with the rider free of auditing cost. This person must be named on the registration form to avoid auditing fees. EVERYONE else will be required to pay an auduting fee of $20 per person taxes included. This will include auditing and lunch. Thank you for your cooperation.
Times/Heights:
 9:00 - 10:30am (x-rail ") 
 10:30 - 12:00pm (2’-23) 
 12-1:30pm 2ft 3" -2 ft 6" 
 1:30-3:00pm (2’6" – 2’9") 
 3pm-4:30 (2’9" – 3’0"+) 
Your selection will be tentative, as we will do our best to fit groups accordingly. There may or may not be a lunch break. Riding times will be announced by phone, email or posted on line 24 hrs prior to the clinic. Please contact Heidi to confirm riding times prior to clinic
Checkbox
 First option 
 Second option 
 Third option 
Please check if you are requiring a stall:
Stall fee is $30/Day $50/Overnight
 Day Stall 
 Overnight Stall 
 Horse Rental $25 
Please note: A photocopy of UTD Vaccinations must be provided to Rushmount prior to entering the stall. Stalls are limited, so book early!
Total Clinic Fee:
All Clinic fees are $150.00 tax & lunch included.
(with the exception of the 2day Despooking clinic is $230 tax and lunch included.) Horse rentals of $25 apply to those using school horses.
*
$
Dollars
.
Cents
NON REFUNDABLE Deposit of 50% paid upon registration via:
Contact Heidi Mueller directly to make payment (705) 826-4677 Thank you!
 Cheque 
 Visa 
 Mastercard 
 Cash 
 Debit 
 Email Money Transfer 
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Rushmount Equine Sports Ltd, Heidi Mueller,
Mikeael McCahon, or any agent thereof shall not
be held liable for loss due to, but not limited to,
injury of any kind, illness, fire, theft, or accident
incurred.