Picket Hill Equestrian Centre Hosts:

Jen Hamilton Jumping Clinic

July 22nd and 23rd
Jen Hamilton NCCP Level 4 Coach

Jen Hamilton Jumping Clinic Registration

Registration deadline with 50% deposit due May 31st, 2016, balance due July 1st. No Exceptions
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Email: _______________________________________________________________________________
Telephone Home: __________________ Work: _____________________ Cell: ___________________
Clinic comprises of:
2 x 90 minute group lessons over two days
Current level/height requested for lesson:___________________________________________________
Goals for 2016:_________________________________________________________________________

Clinic Fees
Clinic Fee

$ 250

Picket Hill Horse Lease

Audit Fee per day

$ 50
$ 25

Facility Fees
Day Stabling Fee (daytime use of stall for both days)
Overnight Stabling Fee (Thurs/Fri night stay over, daytime use of stall for duration of clinic)

$ 40
$ 70

Owner of horse is responsible for hay, feed, etc and will be required to muck out their stall upon departure.
Cheques made payable to Picket Hill Equestrian Centre
Visiting horses must provide proof of vaccinations for flu/rhino, coggins and strangles

Clinic Fee
Stabling Fee.
HST ..
50% non-refundable deposit due May 31st, 2016..
Balance due July 1st , 2016.

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Send Registration to Event Location: Picket Hill Equestrian Centre, 50 Kingsley Road, Esteys Bridge, NB,
E3G 6E3.
NFS cheques will be required to pay banking fee(s).

Picket Hill Equestrian Centre Disclaimer Form

Please read the following very carefully. If you have any questions please contact Sarah King (506-4422299, or pickethill@hotmail.com). Please be sure to understand fully before signing.
Not withstanding anything to the contrary contained within. It is understood that each entrant by the
act of exhibition waives all claims against the Clinic Organizing Committee, and or the members, officers,
and agents thereof (hereinafter called the committee) for any and all injury, loss or damage which the
entrant may sustain or incur as a result of or rising out of the operations or the activities of the said
committee.
The entrant, his/her/its heir, successors, administrators or assigns further agrees to indemnify the said
committee by reason of any claim whatsoever made by administrators, successors, or assigns.
The entrant further agrees that the entrants members, officers or other agents shall be the sole risk and
the responsibility of the said entrant.
The entrant (or guardian, where applicable) acknowledges that he/she/it has read and perfectly
understands the above document and is in full agreement with its contents.
This document shall be binding on the entrant, his/her/its heirs, successors, administrators, executors,
and assigns.
I hereby waive all claims against Picket Hill Equestrian Centre, the Picket Hill Jumper clinic, and its
organizers, for any and all injury which may result on the grounds of the clinic.
Dated at: _____________________(town/province)______________ (province) this ______ day of
___________________ (month), 2016.
Signature: _________________________________________________________________
I/we hereby confirm that there is liability coverage in force with respect to the ownership of the
competing horse(s).
Signature of Rider: ___________________________________________ Date: _________________
Signature of Owner: __________________________________________ Date: _________________

THIS DISCLAIMER FORM MUST BE COMPLETE AND ACCOMPANY YOUR ENTRY FORM
No entries will be accepted without this signed form and copy of current NBEA membership. Additional
forms may be required by Picket Hill Equestrian Centre.