Sand Dance Equestrian Clinic Registration Form April 11th / 12th 2026

Sand Dance Equestrian Clinic Registration Form April 11th / 12th 2026

Please use this form to register for the Sand Dance Equestrian Horsemanship 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 Felicity Mitchell 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 5 weeks (14th March 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*

DayMonthYear
Date
Please check the box to confirm: I consent to the conditions above regarding payments 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

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, although you may need to purchase and extra yard.

My Products

Fence Sitting Saturday 11th and Sunday 12th April Saturday and Sunday, tea breaks and lunch included

$90.00AUD Quantity

Fence Sitting Saturday 12th Tea breaks and lunch included

$50.00AUD Quantity

Fence Sitting Sunday 12thIncludes 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

CampingCamping 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
Friday
Saturday

Item subtotal:$0.00AUD

bunk houseIf 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
Friday
Saturday

Ridden Clinic Saturday 11th and Sunday 12th April 2 Days ridden clinic with Felicity Mitchell, BYO horse, tea breaks, lunch, camping and horse yard inclued

$365.00AUD

Total

$0.00AUD

Should be Empty:

Sand Dance Equestrian Clinic Registration Form April 11th / 12th 2026

Participant Information

Emergency Contact

Extra Information & Special Requirements

Consent & Acknowledgments