Kathy Farrokhzad Registration

Kathy Farrokhzad Registration
Kathy Farrokhzad Clinic
November 10
Participant*

Full NameDate of Birth
Contact Information*

Email AddressPhone Number
Horse Information*

Horse NameDate of Vaccination
Stable and Coach

Stable NameName of Coach
My Products*
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Private Session
45 minute session

$100.00CAD

Semi Private
45 Minute session, 2 Particpants

$85.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD
I, First Name* Last Name* , hereby acknowledge by completing this form agree to pay the full amount after submission. I acknowledge that registration is not guaranteed until payment has been made.

Etransfer payment to: renatemcgillivray@outlook.com
Under Memo, Please put: Participant Name and Clinic
Once all entries have been collected, an Email will be sent with the schedule for the day.
Date*

MonthDayYear
Date
Should be Empty:

Kathy Farrokhzad Clinic