Pre – Registration for the

 Julio Mendoza Dressage Clinic

Open Dressage Clinic – All is Welcome

Presented by Four Winds Farm

You are cordially invited to participate in a one of a kind open Clinic with Julio Mendoza,

This is a great way to get a jump on this years show season & your 2011 training regimen.

Name: __________________________________________

Address: _________________________________________

Phone: ________________E-mail_____________________

The Clinic will be held on ____________________________

Are you interested in Auditing? _____________________________?

Are you interested in Riding? _______________________________________

Do you have a preferred time? _______________________________________________________

Do you wish ride with one other person in a double lesson? ________or Private?___

Do you need stabling?______ fee is $35 each day

Clinic will be held at:      Four Winds Farm

                                                   5157 Jolly Acres Road

                                       White Hall, MD 21161

   Clinic Fees

 Audit:  $15 per day Lite lunch included

Lessons are:   $130 for a private single 45 min lesson and  Double lessons are $65 per horse (two riders share a 45 to 60 min lesson)

 In-hand work is also welcome

…………………..

All Riders please include your Neg. Cogging, current shots including rhino /EHV

( The Rhino shot must not of been given within 10 days prior to clinic) with your release, stall reservation, and Survey

……………………………………

In Consideration of being permitted by Four Winds Farm , Melanie & Thomas Adams., (the Clinic/Farm) to enter onto the premises and participate in a program or activity. I hereby agree that I, my assignees, heirs, distributes, guardians, their legal representatives will not make a claim against, sue, or attach the property of where the clinic will be held in addition to Julio or Jessica Mendoza, and /or the Mid Atlantic Lipizzan Association any of  the aboves principals, agents, employees or representatives, for injuries or damages resulting from the negligence or other acts, conditions, or circumstances, howsoever caused, by any principal. Agent, employee, clinician, or representative of Four Winds Farm its representatives. From all actions, claims, or demands that I, my assignees, heirs, distributes, guardians, or legal representatives now have or may hereafter have for injury or damage resulting from my presence at The Clinic or from my participation in a program or activity at The Clinic.

Signature____________________________. Date__________________

__________________________Signature of Parent /Guardian if rider auditor is under 21.

You can mail forms to and make checks payable to:

 Melanie Adams c/o Mid Atlantic Lipizzan Association

 5157 Jolly Acres Road White Hall Maryland 21161

Please submit your forms and payment in full now to reserve your slot limited space available. All Applications are due by March 6

FMI you can email me at madams8550@aol.com or call my cell 443-220-6058