BTM Host Agreement

Host Name*

First NameLast Name

Host Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Host Email*

example@example.com

Host Phone Number*

Please enter a valid phone number.

Clinic Date Reservation*

Clinic Start Date*

Clinic End Date*

Venue Contact Name

First NameLast Name

Clinic Venue Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Venue Contact Email

example@example.com

Venue Contact Phone Number*

Please enter a valid phone number.

Cost of Facility per day

What type of Attendees would you like to cater to???

Beginners in Breaking the Mold Program?Beginners & people that have been to 2-3 clinics?People that have been to to 2-4 clinics?People that have been in program 4 plus years and really live and breathe it?

What Type of Clinic would best suit your needs? Clinics have a minimum of 12 paid participants or Host pays 1/2 of their clinic fee. Clinics only filled w less than 12 paid students Host pays for their clinic also. Clinics w less then 10 will not be able to keep dates with out office approval.

3 Day: #1--Basic Horsemanship (beginners in the program and young horses) 0-3 clinics $7503 Day: #2--Basic Horsemanship/Ground Zero 0 to 4 clinics in program, $750@3 Day: #3--Intermediate Ground zero 4+ clinics riding in Program2 Day: #1-- Introduction to the Program(Beginners in the program & Colts) $650@2 Day:#2-- Intermediate Ground Zero (2 yr or more in program) $650@1 Day: Day Lessons $350 minimum #6 minimum students required (only available before or after a 3 day) (for attendees that have been to 3-4 clinics or been in program for minimum of 1 year)3 Day: #3--Invitation Only-- No Excuse Advanced 3 years or more in program $800@ Paul will invite a Host to fill this out.

Closest Airport*

As a host for a BTM clinic, you agree to:

Find an appropriate venue and confirm it is available for the duration of the clinic;
Send venue contact information via this form to BTM staff for payment of deposit to reserve the venue and provide insurance information if needed;
Send registration/deposit form to anyone interested in attending the clinic (form will be provided by BTM staff);
Ensure that the minimum number of attendees is reached (12 unless otherwise agreed-upon by BTM staff);
Provide six (6) cones, six (6) poles and three (3) barrels for Paul to use during the clinic;
Send final payment form to all attendees (form will be provided by BTM staff) and ensure all final payments are made by 30 days before the clinic start date.

In exchange for hosting a BTM clinic, you will be able to attend the clinic free of charge for one horse. All attendees must be fully paid and the minimum number of attendees must be reached in order for the host to have their clinic fees waived.

I agree to the terms and conditions listed above.*

YesNo

Host Signature*

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