Pathway to Liberty Registration: Part One

Name*

Prefix First Last

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email

Mobile Phone*

Name of Horse*

Barn Name of Horse

Horse Sex*

Age of Horse*

Please enter a number from 4 to 35.

Horse Breed*

Horse Color*

Has your horse been shown in the last 9 months?*

Have you ever attended a clinic with this horse?*

How long have you owned your horse?*

How many rides have you personally put on your horse in the last 6 months?*

Is your horse used to being in an arena with other horses?*

Current Coggins (must be valid through clinic dates)*

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