Clinic Participant Information

Please print these pages and then fill out one form per person/horse combination or auditor.  Place a check mark next to all appropriate boxes. Please Mail Completed Participant Information, Horse Information, Liability Waiver, Clinic Session Sign Up Sheet and Check to (Check payable "TEC"):
 

The Equestrian Center, LLC
4455 Selle Road
Sandpoint, ID 83864

 

QUESTIONS????   EMAIL   or  Call Toll Free  866-904-0111

Name:______________________________________________ Age: (If minor)______

Address:_____________________________________________________________
              (Street)                                               (City)                               (State)              (Zip Code)

Phone:_______________________________________________________________
               (Home)                                              (Work)                                (Cell)

Email:______________________________________________  Fax:______________

Emergency Contact:_____________________________________________________
                                    (Name)                                                               (Phone)

Insurance:____________________________________________________________ 
                      (Carrier)                                                          (Policy Number)

Medical

Medical Conditions:____________________________________________________
                                (Anything you currently or in the past five years have suffered from.)

Allergies:____________________________________________________________

Physical Limitations:____________________________________________________

Recent horse related accidents?____________________________________________

Riding Experience

Experience with horses:_______(yrs)

Riding Interest:_______________________________________________________

Riding Level:_________________________________________________________

Current Goals:________________________________________________________

Future Goals:_________________________________________________________

Frequency of riding/handling horses:_____________/wk

Please tell us about your current riding/horse situation:

___________________________________________________________________

Any other additional information you’d like us to know:

_____________________________________________________________________

_________________________________________________________
Participant
Information		 Horse
Information		 Release of
Liability Forms		 Clinic Session
Sign Up & Pricing