Certification/Continuing Education 2022 Class Registration Form
This form is for registering for classes taught with The Center for Neuromuscular Horse Dentistry, teaching our Natural Balance Horse Dentistry TM paradigm. Please email us at 4thorse@gmail.com to ensure there is room and complete this form for the level you are attending.
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Email *
Name *
Address *
Phone *
Emergency Contact Name & Number *
Occupation *
Previous Horse Experience? (Brief explanation if yes) *
Level Enrolling For *
How did you hear about us? *
Any health issues or concerns we should know about? *
You are responsible for informing the ranch of any dietary concerns, requests or needs.
TOOTHFAIRY EQD, INC and Center for NMHD makes no claim or warranty that completion of any class or course will result in licenser or accreditation to practice equine dentistry in any state or region of the United States. State and/or local regulations and statutes differ substantially. You must determine state or local rules prior to practicing natural balance dentistry at a specific location.
If you agree, please sign below electronically.
Date
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Signature *
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