Registration Form

Equi-Health Canada Registration Form

Please fill in the form below to confirm your spot.
Full Name*

PrefixFirst NameLast Name
Full Name

PrefixFirst NameLast Name
Full Name

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Suggestions or topics you would like to be included in the workshop?
Clinic Date

MonthDayYear
Invoice to be paid upon receipt & clinic registrations will close 6 business days out to allow for shipment of manuals for participants out of the local area. Email equihcplus@gmail.com if you are registering late so instructor can be prepared to assist you.
Dedicated to the life and love of horses
My Products
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Registration Fee
$169.00CAD

Additional Members of same family
$119.00CAD Quantity

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Equi-Health Canada Registration Form