Lendon Gray Clinic Online Registration Form
This form is to be used to register to "Ride" in the clinic and to "Audit" the clinic

Friday May 4, 2018

Northridge Equestrian
167 Old Stage Coach Road
Gilbert, PA 18330

Deadline for submitting Entry Form is April 28, 2018
  • - -
  • Note: You must bring a current Negative Coggins Test (within 12 months) and proof of a current EHV-1 vaccination (within past 6 months), to be presented at the Clinic Registration table, or you won't be able to ride.
  • I understand that upon clicking the Submit button I am obligated to submit payment via the payment method chosen in the payment options section below.

    I also understand that I am required to bring a current copy of a Negative Coggins Test and EHV-1 Vaccination to the clinic or I will not be able to ride in the clinic.
  • Please choose the Payment Option you prefer to use below:
  • Note:
    After clicking the submit button (only click once) wait several seconds for the payment screen to appear (be patient it will appear).
    In the payment screen you have two options:
    1. Use your PayPal account by loggin into your PayPal account(this is the choice at the top)
    2. Click on the button at lower portion of screen labeled "Pay with Debit/Credit Card" to use your card and enter you card information
  • Note:
    When you choose Pay by Check and hit submit the payment check out screen will still appear after a few seconds. Simply exit out of that screen without continuing any further.
    Before hitting submit write down this address to send your check to:
    Jenn Koch 2225 Seipstown Rd, Fogelsville, Pa 18051