Pick Your Poles - Summer Clinic II
July 12 - 13, 2025 Silverthorn Farm: 665 Jefferson River Rd, Athens, GA 30607
Release Forms
If not already signed in 2025, release forms for S-Squared Eventing will need to be emailed in prior to the clinic or handed in at the clinic. Release forms only need to be signed once per year. If needed, release forms will be emailed to riders upon receipt of this entry form. Release forms for Silverthorn Farm can be signed on arrival.
Name of Rider
First Name
Last Name
Best contact email
This is the email where clinic schedules, notification, and information will be sent.
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is Rider a Jr, YR, or Adult?
If Rider is a minor, name of guardian
If Rider is a minor, email of guardian
example@example.com
If Rider is a minor, phone number of guardian
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency contact name (leave blank if Guardian is emergency contact)
Emergency contact phone number (leave blank is Guardian is emergency contact)
Please enter a valid phone number.
Format: (000) 000-0000.
Current riding level of Rider (If jumping, how high is Rider comfortable jumping?)
Horse's name
Horse's age
Stallion, Gelding, or Mare
Highest level of experience of horse (If jumping, how high is Horse comfortable at)?
Clinic options - please choose only one
Saturday (cavalletti, private): $125
Sunday (grid, group): $100
Both days: $200
Stall needed: $50
Total clinic fees
Saturday (cavalletti, private): $125 Sunday (grids, group): $100 Both days: $200 Stall (Saturday AM - Sunday PM): $50 Payment is due by July 5. After this date, no refunds unless the rider's spot can be filled. Refunds will be given if the clinic is cancelled. Payment is accepted through Venmo (@Beth-Stelzleni) or Paypal Friends and Family (bstelzleni@gmail.com).
Comments regarding goals for this clinic, any challenges the horse/rider are currently facing, or any other information it would be good for Beth to know.
Scheduling and stabling requests. (Please note that we will attempt to meet everyone's needs regarding preferences for ride times/groupings but cannot guarantee that all requests can be granted.)
Submit
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