2025 Clinic Registration Form

Full Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Best way to reach you*

CallTextEmailFacebook

Horsemanship Level*

BeginnerBeginner/AdvancedIntermediateAdvanced

Emergency Contact Person*

First NameLast Name

Emergency Person Phone Number*

Area CodePhone Number

Are you a current member of the North Central Liberty Horse Club*

YesNo

Payment*

Generating RELAXATION 10/25/25$100.00

Evansville, WI

Relaxation UNDER SADDLE 10/26/25$100.00

Evansville, WI

Subtotal $0.00Shipping $0.00Total $0.00

A non-refundable $100 deposit is required for ALL clinic registrations to secure your spot.

*A 3% fee will be applied to Paypal payments.

Stall fees and other amenities will be due upon arrival. This form is your commitment to participate in this event and your deposit is non-refundable (besides understandable unforeseen health reasons and family emergencies). If the participant recruits and is able to fill their spot by another participant, 100% of the event fee will be transferred to the new participant.

2025 Clinic Registration Form

Participant Details

Registration Payments