Mounted Games Registration Form

This is a fundraiser for our riding program! Help us continue helping youth learn all things horse by attending!!!

Sunday August 2nd 2026
10am-3:30pm
10:00am Intro to Mounted Games (rules, maneuvers, etc)
11:30am Walk/Trot Riders
1:00pm Walk/Trot/Canter Riders mook game

Limited to 12 entries. Riders must be able to ride at independently.

Name:

Address:

Phone:

Format: (000) 000-0000.

Email:

example@example.com

Horse's Name:

Riding Experience:

Any known medical conditions:

Emergency Contact:

Select One:

Coggins access #:

State:

Date:

Date

(We must have a current coggins before the horse is unloaded from trailer.)

Registration form and fees NONREFUNDABLE clinic fee
due by July 24th

Spot is not held until full fee is paid. Spots are limited so get signed up ASAP!

Check payable to:
Toms Performance
Horses, LLC
2965 Hat Creek Rd
Brookneal, VA 24528

Electronic Payments
Venmo: Danielle-Kernen (0377)
PayPal friends and family: Danielletoms80@gmail.com

I, the camper or guardian of the minor (under 18), enter the above horse at my own risk subject to all rules and regulations of the show and Hat Creek Equestrian. I agree if any injury or death occurs to the animal exhibited, myself or minor exhibitor, spectators, or damage to any personal property on the grounds, that I hereby waive and release any claim to liability whatsoever from Hat Creek Equestrian, all committees, property owners, employees, members, and volunteers whether the injury, death, or damage be caused by gross negligence or simple negligence of Hat Creek Equestrian.

Exhibitor Signature (or guardian if under 18)

Date