Simon Cocozza Clinic at Hurricane Hill Farm

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Emergency Contact Name*

Emergency Contact Phone Number*

Please enter a valid phone number.

Horse's Name

Please briefly describe the type of riding and level of work you are currently doing with your horse. Please note any relevant injuries or rehabilitation considerations, such as kissing spine.

Please select your scheduling preference for each day. If you are willing to do either private or semi-private, please select both. *Prices include Hurricane Hill Farm arena fee.*

Friday September 27th -Evening Lecture with Simon at Hurricane Hill - $40I do not wish to participate on Friday.

Saturday September 28th*

Saturday - Private session - $265Saturday - Semi-Private session - $165Saturday - Auditor - $20Saturday - I do not wish to participate on Saturday.

Sunday September 29th*

Sunday - Private session - $265Sunday - Semi-private session - $165Sunday - Auditor - $20 ($30 total if attending both days)Sunday - I do not wish to participate on Sunday.

Monday September 30th*

Monday - Private session - $265Monday - Semi-private session - $165Monday - Auditor - $20 ($30 total if attending two days, or $45 to attend 3)Monday - I do not wish to participate on Monday.

Stalls may be available on an extremely limited basis. Please contact Marielle directly to discuss stabling options.

I do not require stabling.I will require stabling.I do not require stabling, but I am interested if extra stabling is available.

Please communicate any other questions or pertinent information.

I understand that by completing this form, I intend to participate in the capacity indicated by my selection above, and I agree to pay associated fees. A deposit of $75 per ride is due at the time of entry to reserve a spot, and the remainder of the cost will be due by Friday, September 14th, 2024. No deposit required for auditors. ***Full refunds will be issued in the unlikely event that the clinic is cancelled. The deposit will be refunded if a participant is wait listed. Scratches are not guaranteed a refund, however a refund may be issued if the spot is able to be filled by another participant. Early communication about the need to scratch will improve the chance that a waitlisted rider may be able to fill the spot! Refunds may also be issued at the discretion of the clinician. Paypal or Venmo preferred. PLEASE INCLUDE FIRST AND LAST NAME as it is entered here in the comment with your payment!*

I understand and agree that I am responsible for a deposit today and full payment by September 14th, 2024.I disagree.N/A - Auditor only