Robbie Potter Clinic Registration

Please complete and submit the form below to register for an upcoming Robbie Potter Clinic.

*Please select the clinic you wish to participate in:
*Name
*Email
*Address
*City
*State
*Phone

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*Please select deposit payment method:
I would like to pay online via PayPal. Please send me a PayPal invoice.
I will be mailing my check.
*Will you need to rent an outdoor paddock or stall?
Yes, please reserve a stall for $15 per day. (limited # of stalls are available on a first come, first serve basis)
Yes, please reserve an outdoor paddock for $5 per day. (made up of 2 strand electrical tape)
No thanks, I do not need a stall or paddock.
*We have 3 guest rooms available that share 1 bathroom available for our clinic participants for $20 per night (first come, first serve). Would you like to reserve a bedroom?
Yes, please reserve a bedroom for me.
No thanks, I will make other arrangements or I live close enough to drive back and forth.
Would you like to be added to Zion Farm's email list to receive farm news and info about future clinics?
Yes
No
Is this your first Robbie Potter clinic?
Yes
No
*Do you agree to respect and abide by Zion Farm's Rules & Regulations?
Yes, I agree
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