STRIDE Clinic Rider Marjas Becker

Sept 7, 2008 Application

Rebel Ridge Farm

Anthony, FL

This is going to be a great clinic!! Drivers, please fill out the top of this form. Auditors, please fill out the name/address area. See “Fees” section below. Please remember to sign the bottom of the form.

DRIVER NAME: ____________________________________________________

ADDRESS ________________________________________________________________________

__________________________________________________PHONE#______________

HORSE NAME__________________________________________SEX____________AGE_________

LEVEL YOU CURRENTLY DRIVE: __________ LEVEL OF HORSE’S TRAINING_______________

I would like to work on:__________________________________________________________________

Preferred time ( AM or PM)_____________

Drivers: If you want to apply for a second lesson, please USE A SEPARATE FORM and enclose a SEPARATE CHECK. Second lessons only if space allows. Lessons 45 minutes.

MAIL APPLICATIONS TO:

SuZi, 9030 SE 170 Avenue Road, Ocklawaha, FL 32179

Application must be received by: August 30, 2008

FEES: Driver Fees: First Lesson: $30/members $60 non members. Stall/Grounds fee $10/$15. Second Lesson $60 if space permits (use separate form and separate check).

ENCLOSE COPY OF COGGINS

WARNING: UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS

NOT LIABLE FOR ANY INJURY TO, OR THE DEATH OF, A PARTICIPANT IN EQUINE ACTIVITIES

RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES.

Signature of

Participant/Parent/Guardian___________________________________________________________