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Longlining - Horse Information Form
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Indicates required field
Date of Clinic
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Handler Name
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First
Last
Name of person bringing and handling the horse during the agility session.
Handler Contact Email
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Handler Contact Phone Number
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Horse Name
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Name of Horse participating in the agility session.
Horses Age
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Does your horse have any medical issues we should be aware of? (If yes please give details)
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Do you (handler) have any Medical problems we should know about?
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Please Choose
No
Yes
If yes, please give details:
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Emergency Contact & Tel Number
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Please give a brief description of you horses longlining experience.
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Where did you hear about us?
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I have read and agree to the Terms and Conditions
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Yes, I agree
No, I do not agree
I agree to receiving marketing and promotional materials
Submit