Clinic Booking Form

Clinic Booking Form

Please complete the form below to book a clinic with Kris De Doncker

Clinic 1: 11th to 13th February 2012 - $150 per lesson

Clinic 2: 14th to 16th February 2012 - $150 per lesson

Clinic 3: 18th to 20th February 2012 - $150 per lesson FULLY BOOKED

Please contact us if you wish to be placed on the 'Stand By' List. You will be contacted if there are any cancellations.

	Your Details
Name:
Address:
Suburb:
State:
Postcode:
Telephone:
Email:
Next of Kin:		Phone:
	Horse Details
Horse's Name:
Sire / Dam:
Age of Horse:
Gender:
Level Of Training:

Stabling Required:	Yes		No
	Stable Cost: $15 per day or any part thereof OR $25 (Cleaned) Per day
Clinic Attending:
Time Preference:	Please Note: Your time preference cannot be guaranteed.

Method of Payment:
	Payment in Full is required by 1st February 2012.
	I hereby acknowledge that I ride at my own risk and that I am aware that activities involving horses can be hazardous and that Bloomfield Farm Pty Ltd and/or Kris De Doncker accepts no responsibility or liability for any injury or loss that I or my horse might sustain as a direct or indirect consequence of the activities of the clinic whether such injury is a consequence of any act or omission by Bloomfield Farm Pty Ltd, Kris De Doncker or their, agents, representatives, employees or volunteers. On the basis of these conditions I hereby indemnify them against all liability (including property damage) arising out of or in connection with my participation in this event to the fullest extent permitted by law. (By submitting this booking form you agree to the above.)