Clinic Registration: Thorsten Zarembowicz at Coach House Farm, 2027 Clintonville Rd., Paris, KY 40361

First Name *

Last Name *

Description of Equine and Carriage. Provide any information of what you would like to concentrate on for your lesson(s). *

Address

City *

State/Province *

Zip/Postal Code *

Phone *

Email Address *

Check the clinic date(s) of this registration *

Number of lessons for chosen date(s) *

1

2

Terms and Conditions *

If you are not a Spokes and Spurs, Inc. member, there is a one time only charge of $30 for an individual membership or $35 for a family membership. Membership entitles you to all rights and privileges for all Spokes and Spurs, Inc. activities. You (and family members if submitting a family membership) are covered under our insurance program. You must fill out and pay for your membership either by completing the form on spokesandspurs.com or you may complete a form and pay on the day of your first lesson. Lesson payment ($130 per 45 minute lesson) is due on the day of the lesson. If you must cancel the lesson with less than 24 hours notice, we will expect payment for the lesson.

Please sign *

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