EITAN BETH-HALACHMY CLINIC

REGISTRATION FORM One per horse and rider

July 16, 17, 18

Please fill out the following registration form and send to:

Sunrise Morgans/Ellen DiBella
11875 Delbert Road, Parker, CO  80138
edibella@aol.com
phone:303-841-5210---fax:303-841-5335

Name                                                                                                                                                               ____

Address                                                                                                                                                              ___

Phone                                                                                                             

Email                                                                                                              

Please note that a non refundable 50% deposit must be received to begin process on your requested space.

Please select one or more of the following:

                                                                                                            Friday            Saturday           Sunday

1. Private one hour lesson                                                                _____               _____              ______                                                   

2.  Semi Private Lesson (2 riders) 1 hour                                        _____               _____              ______                                     

3. Group lesson for three days each morning                                _____              ______             ______

4. Auditing @ $25 Per day   9:00-11:30 AM  1-4 PM                       _____               ______             ______

Other services

Stabling @ $25/day per horse---limited space---                                _____              _____                _____

Negaive Coggins required---feed and bedding provided

Must clean your own stall                                              

Hospitality Package:  $50 per day or $125 for three days                    _____              _____               _____

Check Amount ----------------------------------------------$______________________   

Level of horsemanship:                              beginner                             intermediate                advanced

Horse level of ability:      beginner                    intermediate                advanced

Eitan would like to you email him at eitan@follthill.net before the clinic to let him know if you have a particular problem or goal that you would like to address so that he can customize your experience.

By signing below and the required Sunrise Morgans Release and Hold Harmless agreement, you agree to hold Sunrise Morgans, Nicholas and Ellen DiBella and their employees, and Eitan Beth-Halachmy harmless in case of injury or death to you or your horse.

Please sign below that you have read and are in agreement with the program and release to hold harmless.

                                       Signed                                                                       Date