Please fill out separate forms for each entrant.

Name: ______________________________________________________________________

Address: ______________________________________________________________________

Town: _____________________________ State/Prov: _________ Zip: __________________

Phone (days): _____________________________(eves): _____________________________

Horse(s) name(s): ______________________________________________________

- Will you be participating in the full clinic (Saturday and Sunday)?_________________________

- Will you be auditing the clinic?_________________________

- Would you like private lessons on Friday or Monday?_________________-_________

- If so, what days/ times would you prefer? (Please see a list of times below and give at least three options for each lesson you would like to take. i.e.: 1st choice, 2nd choice and 3rd choice. Also please be sure to include your daytime phone number on this form so that we can call you and let you know what time your lesson (s) will be.)____________________________________________________________________________________________________________

- How many horses will you be bringing?___________________

- Will you be joining us on Friday afternoon for a trail ride?______________________________

Registration Fees:

$250 entry fee per rider =

$12 per night stall fee=*

$12 per night refundable cleanup fee=

$45 fee per 1 hr. private lesson=

$25 fee per auditor=

* stalls may be rented at this rate for 1,2,3 or 4 nights.

Other costs: $4 per bale shavings and $2.50 per bale hay will be available to you when you arrive if you do not bring your own.

Your total =

Schedule of Private Lessons:
Friday, May 23rd: 9:30am - 10:30am, 10:45am - 11:45am, 12:00noon - 1:00pm (lunch) 2:30pm - 3:30pm, 3:45pm - 4:45pm

Monday, May 26th: 9:30am - 10:30am, 10:45am - 11:45am, 12:00noon - 1:00pm (lunch) 2:15pm - 3:15pm, 3:30pm - 4:30pm, 4:45pm - 5:45pm.

*please make your inn reservations as soon as possible. See the previous page of this form for a list of inns, or call the Mad River Inn at (802)496-7900. Please make checks payable to: Vermont Icelandic Riding Club. Mail your completed form and check to:

Shirley Bate
202 Percy's Place
Plainfield,VT 05667-9558
or call:
Shirley (802)454-1754 or Jill (802)496-7632
if you have questions.

All horses must have current health papers, including coggins tests, in order to enter the property. PLEASE have these with you in your vehicles when you arrive.

Warning:
Vermont Icelandic Riding Club strongly recommends that all participants in its events wear approved riding helmets with chin straps. Should you choose not to wear a helmet, it is AT YOUR OWN RISK.
Under Vermont State law, an equine activity sponsor is not liable for an injury to, or death of a participant in equine activities resulting from the inherent risks of equine activities that are obvious and necessary, pursuant to 12 V.S.A. 1039.
You will be asked at the clinic to sign a form saying that you have read and understand both of these statements and that you agree to enter this event at your own risk. That you further agree to make no claims against Vermont Icelandic Riding Club, it’s officers or directors, the property owners or the event planners should an accident, injury or loss occur to any horse, rider, spectator, or article sent to this event.