Rushmount's Clinic Series
Clinician: *
 Hyde Moffat | new date Nov 30th 
Your selection will be tentative, as we will do our best to fit groups accordingly. Ride times may vary due to riders needs. 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 note there will be no lunch provided but usually available for purchase.
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 $40 per person taxes included. Thank you for your cooperation. Please contact Heidi to confirm 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 
 Eventing 
Please let us know which discipline you primarily participate in.
HEIGHT REQUESTED
 POLES 
 X RAIL 
 2 FOOT 
 23-26 
 26-29 
 3 FT AND ABOVE 
Please let us know which discipline you primarily participate in.
Preferred lesson type
 Group 
 Semi-Private 
 Private 
Private and semi private may not be available. If they are available it will be at an increased cost.
Please check if you are requiring a stall:
Stall fee is $40/Day $60/Overnight
 Day Stall 45 
 Overnight Stall 80 
 Horse Rental $50 
Please note: A photocopy of UTD Vaccinations must be provided to Rushmount prior to entering the stall. Stalls are limited, so book early! water buckets and shavings will not be suppied.
Total Clinic Fee:
Clinic fees may vary on clinician and type of lesson you requested. ex privates and semis are more than group. *
$
Dollars
.
Cents
All fees subject to HST. Please note Rushmount will cover the auditing fee for one person for each participant. Additional auditors will have to pay an auditing fee of $40
 Cash 
 Debit 
 Email Money Transfer info@rushmount.com 
PLEASE DO NOT PAY THE FULL AMOUNT BY ETRANSFER. PLEASE WAIT UNTIL YOUR SPOT IS CONFIRMED AND THEN SEND DEPOSIT. BALANCE PAID INFULL BEFORE YOU RIDE.
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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.