Clinic Entry Form

Cheryl Keith Clinic

August 30th, 31st, September 1st, 2024

This form is for 1 Horse/1 Rider

Rider Name

First

Last

Horse Name

HCBC #

You are REQUIRED to have an active HCBC membership to attend this clinic.

BCHJA # (Optional)

Height/Level

Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you have a VDRC Membership for the current calandar year?

Yes
No

Waiver

VDRC JR/SR WAIVER HERE

Please follow the link above and fill out the respective waiver (over or under age of majority), then upload your completed form below

Completed Waiver File Upload

Click or drag a file to this area to upload.

Please upload your file here

VDRC VACCINATION FORM HERE

Please follow the link above to fill out the vaccination form, then upload your completed form below

Completed Horse Vaccination Form Upload

Click or drag a file to this area to upload.

Please upload your file here

Fees & Payment

Office Fee

Price: $10.00

Clinic Fee. Please select your respective fee from the dropdown menu below:

Select your respective fee. (Member or Non-Member)

Please select any stabling (and for how many days) you require.

If hauling-in, do not select any stabling.

Box Stall Overnight Use - VDRC MEMBER

Covered Pen Overnight Use - VDRC MEMBER

Open Pen Overnight Use - VDRC MEMBER

Box Stall Overnight Use - VDRC NON-MEMBER

Covered Pen Overnight Use - VDRC NON-MEMBER

Open Pen Overnight Use - VDRC NON-MEMBER

+5% GST

Price: $0.00

Total

$0.00

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