EmailMe Form - Lucinda Green Clinic at Win Green Farm

Name *
First Last
Junior/Senior *
Junior (under 18)
Senior (over 18)
Address *

Street Address City State / Province / Region Postal / Zip Code
Email *
Phone *
### - ### - ####
Clinic Jump Height *
Up to Beginner Novice (2'7")
Beginner Novice/Novice (2'7"-2'11")
Novice/Training (2'11"-3'3")
Training/Prelim (3'3"-3'7")
Prelim and up (3'7" and up)
Horse Name *
Horse/Rider Experience *
Please type a brief description of the horses' and riders' experience. This will help when planning lesson groups.
Payment
Pay Deposit ($200 + $5 convenience fee)
Pay In Full ($400 + $5 convenience fee)
If deposit is paid, remaining balance is due by October 1st, 2019
Upload Coggins
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