Clone of Western Clinic Registration Form

Pierre Briere Western Clinic Registration Form
To be held May 2nd and 3rd at the Princess Louise Show Park in Sussex, NB taught by Pierre Briere
Name

First NameLast Name
E-mail
example@example.com
Phone
Format: (000) 000-0000.
AQHA Membership ID Number (If applicable)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Horse's Barn Name
Are you applying for more than one horse or horse rider combo?
Second Rider's Name
Second Rider's AQHA Membership ID Number (If applicable)
Second Horse's Barn Name
Payment By:
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Pierre Briere Western Clinic (Full Amount)
Two day clinic, price includes a stall in barn 5

$475.00 CAD Quantity
Item subtotal:$0.00 CAD



Pierre Briere Western Clinic (Deposit)
Remainder of $325 is due on or before April 12

$150.00 CAD Quantity



Extra Stall
Cost is per stall, includes Friday and Saturday night, subject to availability

$70.00 CAD Quantity



Trailer Hook Up (Semi)
Includes Friday and Saturday night

$70.00 CAD Quantity



Trailer Hook Up (Full)
Includes Friday and Saturday night

$90.00 CAD Quantity



Shavings (Bag)
Subject to change

$11.00 CAD Quantity



Total

$0.00 CAD
**Deposits are REQUIRED to secure your place in the clinic**

Remainder of $325 and any extra add ons are due on or before April 13th

- One stall is included for Friday and Saturday night

- Trailers can haul in Friday May 1st at 1pm

- Proof of liability insurance is required and a waiver will need to be signed to participant in the clinic
Should be Empty:

Pierre Briere Western Clinic Registration Form

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