Name of Horse___________________________________________________________

Age, Breed, training/competition level_________________________________________

_______________________________________________________________________

Goals and Challenges______________________________________________________

________________________________________________________________________

Rider Name, Address, phone, email __________________________________________

________________________________________________________________________

Owner Name address, phone, email___________________________________________

________________________________________________________________________

Release: The above agrees to participate in events at Pacific Moon Equestrian Center at his/her own risk and responsibility and shall hold harmless the clinician, Pacific Moon Equestrian Center LLC, it's heirs, descendents, employees, volunteers, representatives and assigns from any and all liability for damages or injury, including death, to any person or property. For their safety, participants agree in advance to follow the directions of PMEC staff and representatives.

Special Instructions/Stabling: Riders may bring one groom and/or owner to assist at no charge. Auditors are welcome @ $20 per day. Limited stabling is available on a first come first serve basis. A $40 stabling fee, from Saturday morning through Sunday afternoon (Fri-Sun $60), includes 2 daily feedings (7am. & 4pm.), bedding and cleaning each morning. We will feed our hay (Orchard or timothy grass) or you may provide your own. Please bring your own grains and/or supplements in zip lock baggies, one baggie per feeding. Please use your stall to groom.

Clinic Fee $____________ $140 Private
Clinic Fee$ _____________$110 Semi Private
Stabling $ ___________ $40 or $60
Total $____________

Make checks payable to Pacific Moon Equestrian Center and mail to:
14432 Jim Creek Road, Arlington, WA 98223 - 360-403-3035

Driving Directions: Take exit 208 off I-5, stay east on Hwy 530 for 3 miles. Go left onto Hwy 9 for one block. Take the next right staying on Hwy 530 east. Go straight through 4 way stop. Take first right after the soccer fields onto Arlington Heights Road. Pacific Moon is 4.7 miles on your left.

Owner or Parent of riders under 18 y.o. Signature & date _______________________

Owner Signature & Date 18 years of age and older _____________________________

Use the buttons below if you would like to use a 
credit card to pre-register for an upcoming event

Clinic Fee- Private $140
Clinic Fee- Semi-Private $110
Stabling Sat-Sun $40
Stabling Fri-Sun $60
Day Stalls-$20
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