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Greg Eliel's Foundation Clinics |
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70 Ross Road, Ellensburg, WA 98926 |
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(509) 968-4234 | Fax: (509) 968-4233 |
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Clinic Sign-Up Sheet |
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-- Clinic Information -- |
| Clinic Sponsor _________________________________________ |
| Clinic Location _________________________________________ |
| Clinic Start Date ______ - ______ - ______ |
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-- Participant Information -- |
| Name ________________________________________________ |
| Address ______________________________________________ |
| City ________________________, State ____ Zip Code _________ |
| Phone ( _____ ) ______ - _________ Cell ( _____ ) ______ - _________ |
| Emergency ( _____ ) ______ - _________ |
| Veterinarian ( _____ ) ______ - _________ |
| CLINIC | START DATE | No. of HORSES | PRICE | DEPOSIT (Non-Refundable) | BALANCE DUE |
| 1-Day Demonstration | ____-____-____ | ( ) | $______ | $100 | $ ______ |
| 5-Day Restarting | ____-____-____ |
( ) |
$______ | $150 | $ ______ |
| 4-Day Horsemanship | ____-____-____ |
( ) |
$______ | $150 | $ ______ |
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Total Due: |
$ ______ |
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Please make checks payable to "Greg Eliel Clinics" |
| I understand that my slot in a clinic will only be reserved by the receipt of my deposit; that my deposit is non-refundable; and that, in case of a clinic cancellation, deposits will be refunded or applied to another clinic. |
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Signature: ___________________________________ Date: ______________ |
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Mail or fax the Sign-Up Sheet. Thank you. |
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