Anna Blake:

Relaxed & Forward

NZ tour 2018 - Registration form
Cambridge clinic
CLINIC DETAILS
Date / time: 3rd, 4th & 5th February 9am registrations, 9.30 start (each day)
Venue: Cambridge RDA corner of Alpha & Hall Streets
Host: Bex Tasker 0214400078; PositivelyTogetherNZ@gmail.com
Format: Day 1 (Sat 3rd): Calming Signals & horse agility (on the ground)
Day 2 (Sun 4th): Dressage Rhymes with Massage (ridden)
Day 3 (Mon 5th): Rhythm and Dance (ridden)
See Annas website for more information on clinic topics.
Clinic fee One day: $150
(with horse): Two days: $300
Three days: $400
Prices are inclusive of arena fees, lunch and tea/coffee.
Overnight fees: $10 per person per night camping (or 3 nights $20)
$10 per horse per night paddock/yard (or 3 nights $20)
Auditor fee: $30 / day

ATTENDANCE OPTIONS
Please mark the relevant options:
With horse: __ Day 1 ___ Day 2 ___ Day 3
Auditor: __ Day 1 ___ Day 2 ___ Day 3

PARTICIPANT DETAILS
Name:
Name of guardian (if under 18
years)
Age (if under 18 years)

Email:
Phone:
Address:
Emergency Name:
contact: Phone: Relationship:

If attending with horse:

Horses name: x Horses age: x
__ Mare __ Gelding __ Stallion __ Hack __ Pony __Mini
OVERNIGHT ARRANGEMENTS
Horse stalls/yards have rubber matting so bedding is required for overnight (e.g. straw or
hay). Paddocks and stall space for overnight stays is limited, and priority will be given to
those travelling long distance.
Please advise requirements including whether your horse can be paddocked with others.
Please detail any overnight requirements for your horse here: x

Camping for the humans: toilets and kitchen available on site, showers are 10 min walk
away at the Community Centre and use an honesty box system for donations.
Please advise how many nights camping you require: x

PAYMENT
Deposit: 50% deposit (please note your place is not confirmed until this form is
received and the deposit is paid).
The organiser will email you to confirm there is a spot available for you, and
provide bank account details for your deposit.
Deposit is due within 5 working days of email confirmation from the
organiser.

Balance: Balance to be paid by 17 January 2018

Cancellation policy
Deposits are non-refundable, unless the clinic is cancelled by the clinician and/or the
organisers.
Refunds on remainder of fees cannot be guaranteed, but may be considered at the
discretion of the organisers, dependent on filling a rider's place from a waiting list.

INDEMNITY
I agree to the following statement:
I, , apply to participate in this clinic of my own free will and at my own risk. I
understand that handling and riding horses is a dangerous activity and that horses can act
in sudden and unpredictable ways. I agree to keep my horse under control and wear
appropriate footwear and an approved safety helmet when riding. I give my consent to
receive any first aid and/or medical treatment which may be deemed advisable in the
event of accident, injury and/or illness as a result of my involvement in this event. I agree
that photos or video of myself and/or my horse taken during the clinic may be used by
Anna Blake for publicity or sales purposes.
Date:

Please email the completed form to Bex at PositivelyTogetherNZ@gmail.com

You will receive a reply email confirming whether there is a spot available for you.
If so, bank account details for your deposit will be provided.
Payment is due within 5 working days of email confirmation sent from the
organiser, otherwise the spot will be opened up again for the next person.