OLYMPIC PENINSULA PERFORMANCE HORSES
2012 CLINIC APPLICATION
RHONDA HEINER HORSEMANSHIP CLINIC
JUNE 16 & 17, 2012
Name: __________________________________________________________
Address:___________________________________________________________________
City: ______________________________________ State: _________ Zip: _____________
Home Phone: ________________ Cell Phone: _______________ Other: _______________
Email address: ______________________________________________________________
Emergency Notification: ____________________________ Phone #: __________________
Doctor: _____________________ Phone: _______________ Insurance: ________________
Any allergies or medical issues that need to be addressed?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Riding Level
(please circle to your best knowledge)
Beginner: First timer or limited riding experience.
Novice: Can ride a gentle horse at a walk & trot independently.
Intermediate: Can control the horse at a walk/trot and has cantered/loped before.
Advanced: Can control the horse at a walk, trot, and canter/lope.
Tuition:
Horsemanship Clinic, June 16 & 17, 2012
(10:00am - 3:00pm Saturday; 10:00 am – 1:00 pm Saturday) $115.00/ WEEKEND
Mail to:
OPPH
P.O. Box 1239
Carlsborg, WA 98324
Phone (360) 775-5084
Please make checks payable to Sara Richerts and mail to above address with clinic paperwork.
*Full payment and all clinic forms are due on or before the first day of clinic*
2012 CLINIC APPLICATION
RHONDA HEINER HORSEMANSHIP CLINIC
JUNE 16 & 17, 2012
Name: __________________________________________________________
Address:___________________________________________________________________
City: ______________________________________ State: _________ Zip: _____________
Home Phone: ________________ Cell Phone: _______________ Other: _______________
Email address: ______________________________________________________________
Emergency Notification: ____________________________ Phone #: __________________
Doctor: _____________________ Phone: _______________ Insurance: ________________
Any allergies or medical issues that need to be addressed?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Riding Level
(please circle to your best knowledge)
Beginner: First timer or limited riding experience.
Novice: Can ride a gentle horse at a walk & trot independently.
Intermediate: Can control the horse at a walk/trot and has cantered/loped before.
Advanced: Can control the horse at a walk, trot, and canter/lope.
Tuition:
Horsemanship Clinic, June 16 & 17, 2012
(10:00am - 3:00pm Saturday; 10:00 am – 1:00 pm Saturday) $115.00/ WEEKEND
Mail to:
OPPH
P.O. Box 1239
Carlsborg, WA 98324
Phone (360) 775-5084
Please make checks payable to Sara Richerts and mail to above address with clinic paperwork.
*Full payment and all clinic forms are due on or before the first day of clinic*
