Nona Garson Winter Clinic Registration Form

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Nona Garson Clinic Registration Tuesday and Wednesday, December 30 and 31, 2014 The Ridge @ Wellington 14415 Palm Beach Point Blvd Wellington, FL 33414 Rider Name _______________________________________________________ Rider Address

________________________________________________ ________________________________________________

Adult or age of Junior ____________

Telephone: _____________________________________

e-mail _____________________________ Alternate Phone _________________________________

Name of Horse ________________ Mare or Gelding _____ Ht._____ Color ______ Please circle Approximate jumping height desired:

2’6 and below

2’9”

3’

3’3”

3’6 plus

The event is designed to be a 2-day clinic. Single day participation is subject to availability. Exact times for each section will be confirmed 5 days prior to clinic start. Since groups will be divided according to experience and ability, please describe briefly your current riding level/show experience:

_______________________________________________________________________________________ _______________________________________________________________________________________ ______________________________________________________________________________________ Please send or fax (*) your payment of $450 for a 2-day clinic (plus horse lease payment if applicable) payable to The Ridge Farm along with this form by any method as follows: The Ridge Farm / Nona Garson 14294 Stroller Way, Wellington, FL 33414 FAX:561-791-1543 Scan and email to: NonaRidge@aol.com (*) faxed forms will only be confirmed upon receipt of payment or if accompanied with credit card information. Method of Payment (circle):

Check

Cash

Credit Card: Visa

MasterCard

Amex

Number__________________________________________________ exp. date____________ CID # _______________ Please provide billing name and address associated with credit card: ________________________________________________________ ________________________________________________________


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