Lake Shore Region Concussion & Code of Conduct Forms

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This online form MUST be completed by the Member & a Parent and submitted once per year to Lake Shore Region Pony Club. This online form must be completed prior to being allowed to participate in Pony Club activities in Lake Shore Region.

Email *

Club/Center that Chaperone is affliated with *

Big Bay

Birchwood

Dune Riders

Erin Winds Equestrian Pony Club Riding Center

Fox Valley

Hillside Farm

Kuenzi Equestrian Pony Club Riding Center

Lake Geneva Area Equestrian Pony Club Riding Center

Lake Superior

Lakefield

Misty Morning Farm Pony Club Riding Center

Racine County

River Run

Run O' the Mill

Other Pony Club not in Lake Shore Region

If answered Other for club affiliation, please explain

Member First Name *

Member Last Name *

Parent First & Last Name (if member is under 18 years of age on Jan 1)

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