Let's get to know you!

Clinic Registration Step 1 of 3

Please complete the form below to tell us more about you, your horse, and your goals:

About You

Full Name *

Address *

City *

State *

Zip Code *

Email *

Phone Number *

For Minors Under 18 Years of Age

Minors under 18 MUST wear a helmet.

Name of Parent(s) or Guardian

Participant Birth Date

About Your Horse

Your Horse's Name *

Breed *

Age *

Sex *

Mare

Gelding

Stallion

Owner Name and Phone Number *

Vet Name and Phone Number *

Allergy/Medical Conditions *

If possible, please submit your horse's negative coggins and vaccine record:

Emergency Contacts

Emergency Contact Name and Relationship #1 *

Phone Number *

Emergency Contact Name and Relationship #2 *

Phone Number *