Platinum P Ranch Clinic Form Becky Terrell

Platinum P Ranch Clinic Form

September 26, 2025 4pm - 7pm
Thank you for pre-registering for our upcoming Pattern Placement clinic with clinician Becky Terrell on Friday, September 27, 2025! Only TWELVE (12) spots are available. The clinic sessions are a first come first serve basis. You must fill out one form PER PERSON.

Please verify you received an email confirmation upon submission of form.

I'm the event the clinic is full, a waitlist option is still available. Registration and prepayment are required to be added to the waitlist. In the event there are no cancellations, then your payment can be credited to your show fees the next day, Saturday, September 6, 2025, or it can be refunded. Payment is due upon submission of this form.

Refund Policy: You must provide a 24 hour notice in order to receive a refund.

If you have any questions about this form, need to cancel, or make changes, please text or call Sarah Stull-Plumbtree at 540-604-3938 or email at contact@platinumpranch.com

1267 FM1815, Nocona, TX 76255
Rider Name*

First NameLast Name
Horses Name*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PRE-PAYMENT IS REQUIRED TO HOLD YOUR SPOT. PLEASE USE THE QR CODE OR VENMO @ PLATINUMPRANCH. CHECKS ARE ALLOWED IF POSTMARKED FOR JUNE 5TH AND RECEIVED BEFORE THE CLINIC.

Mail check/cash to 3012 Denver Ave, Aubrey, TX 76227
Clinic Cost - $80 nonrefundable (Includes Lunch)*

$160$40 Auditor (Spectator)
Do you require a printed invoice?*

YesNo
Payment Type*

VenmoCheck is in the mailCash in the mail
Mail check/cash to 3012 Denver Ave, Aubrey, TX 76227
Photo Release*

I grant my picture to be taken for media and promotion.I deny my picture to be taken for any reason.
Coggins: Negative Coggins are required. Please upload or bring it to the clinic.

Cancelof
UNDER TEXAS LAW, AN EQUINE SPONSOR OR PROFESSIONAL SHALL NOT BE LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE)

BY MY SIGNATURE BELOW, I HEREBY ACKNOWLEDGE THAT I UNDERSTAND THAT RISKS INVOLVED IN RIDING HORSES AND VOLUNTARILY ASSUME THOSE RISKS. I AGREE THAT I WILL NOT HOLD PLATINUM P RANCH LLC AND/OR THE SHOW FACILITY (DIAMONDS SPLIT RANCH), NOR ANY OF THEIR DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, OR PARTICIPANTS, LIABLE FOR ANY INJURY.DIAMONDS SPLIT RANCH IS A WORKING RANCH WITH HORSES, DOGS, LIVESTOCK, MOTOR VEHICLES, CHILDREN PLAYING, ETC AND I TAKE FULL RESPONSIBILITY FOR MY ACTIONS.

DOGS MUST BE ON A LEASH AT ALL TIMES.
I HAVE READ AND UNDERSTAND THE ABOVE AND DO AGREE TO IT'S TERMS.I HAVE READ AND UNDERSTAND THE ABOVE TERMS DO NOT AGREE.
Signature*

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