Equi-Health Canada Plus - Online Interactive

Equi-Health Canada Registration Form

Please fill in the form below to confirm your spot.
Full Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Suggestions or topics you would like to be included in the workshop?
Clinic Date

Month Day Year
Date

Registration Fee

Registration Fee (Required) $ 79.50 CAD

Quantity
Item subtotal: $ 0.00 CAD

Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Invoice to be paid upon receipt & clinic registrations will close 6 business days out to allow for shipment of manuals for participants out of the local area. Etransfers accepted at equihcplus@gmail.com password horses
Dedicated to the life and love of horses
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