First Name:                               Last Name:                          

Street Address:                          

Street Address (2):

City:                                   State: AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OJ OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY         Zip code:  

Phone numbers (please include area code)

Home:                                          Work:                                           Cell:                          

E-mail address:  

Where did you hear about us?:

Dates of clinic you wish to attend:    < select one > One Day Clinic - May 9, 2009 One Day Clinic - May 23, 2009 One Day Clinic - June 20, 2009 Two Day Clinic - May 2-3, 2009 Two Day Clinic - June 6-7, 2009 Two Day Clinic - June 13-14, 2009 One Week Clinic - Sept 1-6, 2008 One Week Clinic - May 25-30, 2009

What do you hope to accomplish in this class?
 

Any other questions or concerns?

Photo Release:  I give my permission to The Common Horseman, LLC and any/all of its affiliates to take video and/or still pictures of me and my horse before, during, and after class, and to use said photos in any promotional or other materials.  

     I agree to the photo release I DO NOT agree to the photo release

Liability Release
I realize that horses are dangerous animals.  I assume ALL risks, known and unknown, seen and unseen, and hereby release all individuals, The Common Horseman, Let’s Ride Ranch, and its affiliates, of any liability for loss, illness, damage or injury, to my self or my horse, including death.

  Please acknowledge this release I AGREE to the liability release

You must accept the liability release in order to attend the class.

Please send your check or money order payable to The Common Horseman, LLC and send to:

The Common Horseman, LLC
10498 45th Avenue NE,
Sauk Rapids, MN 56379