Angie Wicks Clinic Registration Form July 17th / 18th / 19th 2026

Angie Wicks Clinic Registration Form July 17th / 18th / 19th 2026

Please use this form to register for the Angie Wicks clinic - an invoice for payment will follow.
Participant Information

Please provide the participant’s basic details as they should appear on clinic records.
Participant full name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email address*
example@example.com
Mobile phone number*
Please enter a valid phone number.
Age of participant if under 18 years*
Please note riders under 18 years MUST wear a riding helmet
Parent/guardian full name (if participant is under 18)

First NameLast Name
Date

MonthDayYear
Date
Rider experience level

Beginner (little or no riding experience)Novice (walk/trot, learning to canter)Intermediate (comfortable walk/trot/canter)Advanced (experienced with various horses and gaits)NervousinstructorTrainer non professionalTrainer professionalOther
Rider Interests

trail ridingwestern pleasureDressageEventingCompetitive ShowingHackingPony ClubPolocrosseReiningCuttingCamp draftingOther
Have you have a lesson with Angie Wicks before

yesno
What would you like to learn / focus on / get out of the clinic
Emergency Contact

Provide details for someone we can contact in case of an emergency during the clinic.
Emergency contact full name*

First NameLast Name
Emergency contact phone number*
Please enter a valid phone number.
Relationship to participant*
Extra Information & Special Requirements

This information helps us support the participant’s safety and comfort during the clinic.
Please list any medical conditions, allergies, or injuries we should be aware of
Please list food allergies or requirements here
Consent & Acknowledgments

I understand that by making a payment for the ridden clinic and / or the ground work clinic the initial deposit of 50% is non- refundable, unless Capricorn Equestrian Centre can find a replacement rider. The full payment for the clinic is required 6 weeks (5th June 2026) before the start of the clinic, from that point it is non-refundable unless a replacement rider is found. In the case of Capricorn Equestrian Centre cancelling the clinic, there is a 100% refund of clinic fees paid
Name of consenting adult (participant if 18 or over; parent/guardian if under 18)*

First NameLast Name
Date of consent*

MonthDayYear
Date
Please check the box to confirm: I consent to the above conditions and certify that the information provided in this form is accurate and complete to the best of my knowledge.*

I confirm that all information provided is accurate and complete.
Please tick the boxes below to indicate which days you will be attending, an invoice will be sent out where you can pay online or direct debit into our account

The Friday Ground work clinic is pending having enough participants, we need 10 to ensure the groundwork clinic goes ahead. The decision will be made at the end of February to allow flights to be purchased.

Fence sitters - tea breaks and lunch are included please bring a comfy chair and always good to have a note book and pen as well. If you would like to camp this is an extra fee.

Riders, camping, tea breaks, lunches and one horse yard are included in the fees. The bunk house is an extra fee.

If you would like to bring more than one horse this is permited, you may need to purchase and extra yard.

My Products

Friday 17th July Ground Work Clinic

This is subject to having enough participants by Feb 28th.

$210.00AUD Quantity

Friday 17th July FENCE SITTING Ground work

This is subject to having enough participants, by Feb 28th.

$50.00AUD Quantity
Item subtotal:$0.00AUD

Saturday 18th and Sunday 19th July RIDDEN Clinic

Saturday 8am - 5pm Sunday 8am - 4.30pm Tea breaks and Lunch, camping and one horse yard included in fee.

$440.00AUD Quantity
Item subtotal:$0.00AUD

Saturday 18th and Sunday 19th July Fence Sitting

Saturday and Sunday, tea breaks and lunch included

$90.00AUD Quantity

Saturday 18th Fence Sitting

Tea breaks and lunch included

$50.00AUD Quantity

Sunday 18th Fence Sitting

Includes tea breaks and lunch

$50.00AUD Quantity

Horse Yards -

One free horse yard per ridden participant - this is extra horse yards if you are bringing more than one horse

$10.00AUD Quantity

Camping

Camping is free to participants - this is if you are bringing extra people or you are a fence sitter who would like to stay over

$10.00AUD

	Quantity
Thursday
Friday
Saturday

Item subtotal:$0.00AUD

bunk house

If you would like to sleep in our glamping bunk house - bunk bed with linen and blankets. Toilets and hot shower in shed next door. Very basic with small fridge.

$25.00AUD

Color	Quantity
Thursday
Friday
Saturday

Total

$0.00AUD

Should be Empty:

Angie Wicks Clinic Registration Form July 17th / 18th / 19th 2026

Participant Information

Emergency Contact

Extra Information & Special Requirements

Consent & Acknowledgments