Jerry Schurink Clinic - March 8-9, 2025
Date:   Saturday, March 8 & Sunday, March 9, 2025
Apple Knoll Farm, 25 Forest Lane, Millis, MA  02054
events@appleknoll.com

TIMES: Please include your preferred day or days and time slot (AM or PM) below.  
Schedule will be posted on our website and Facebook page.  Clinic schedule is subject to change at any time.  

**It is the RESPONSIBILITY OF THE ENTRANT (OR ENTRANT'S GUARDIAN) to check the times for updates.**    

STABLING: Limited on-site stabling available for this event. 
Please contact  Adrienne Iorio for stabling information.
  
PAYMENT: Venmo instructions are provided in "Payment Method" section below.  
Payment due upon submitting entry.  

$10 Late fee may apply after 24 hours of non-payment after submitting entry.  
**NO REFUNDS OR CREDITS after closing date, unless space can be filled ($25 office fee).**  

RATES (ALL Fees Non-Refundable):
  • Private - $215
  • Semi-Private/Group (Jump or Flat) - $135
  • Auditor - $ 20/day
RELEASE: Online liability release ALL RIDERS, GROOMS, AUDITORS & VISITORS TO APPLE KNOLL MUST SIGN THE LIABILITY RELEASE PRIOR TO ATTENDING

COGGINS: Current negative Coggins must be e-mailed to Adrienne Iorio prior to arrival at Apple Knoll Farm.  

RULES:
  • Apple Knoll Farm reserves the right to decline any entry for any reason.
  • ALL areas of the farm, except the designated riding areas, are restricted.
  • Dogs MUST be on leash and non-disruptive.
  • USEF, USEA, and USDF guidelines apply.
  • Certified helmet with attached chinstrap required when mounted.  Clinic attire accepted.
  • Clinic will run regardless of weather.
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Email *
Rider First Name: *
Rider Last Name *
Rider Date of Birth *
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Rider (or Guardian) Phone: *
Rider Address (Complete Mailing Address Required): *
Horse Name (Email Coggins Prior To Arrival To Adrienne Iorio): *
Emergency Contact Phone: *
Clinic Day(s) & session type:
Dressage
Jumping
Saturday, March 8
Sunday, March 9
Please provide ideal ride time (we will do our best to schedule you around this time frame): *
Please list names of riders in semi-private/group:
Rider Level: *
Fees: *
Payment Method - 

Payment due upon submitting entry. 
$10 Late fee may apply after 24 hours of non-payment after submitting entry. 

No Refunds or Credits After Closing Date, NO EXCEPTIONS

Please Be sure to note in the payment details the Rider's First / Last Name, Jerry Schurink  March 8-9, 2025 Clinic: *
 *
Please add your Venmo/PayPal Username:
I consent and agree that use of a key pad, mouse or other device to select an item, button, icon or similar act/action while using any electronic service Hatrick, Inc., Apple Knoll Farm or their agents offers, or in accessing or making any transactions regarding any agreement, acknowledgement, consent, terms, disclosures or conditions constitutes my signature, acceptance and agreement as if actually signed by me in writing.  Further, I agree that no certification authority or other third party verification is necessary to validate my electronic signature below; and that the lack of such certification or third party verification will not in any way affect the enforceability of my signature or resulting contract between me and Hatrick, Inc, Apple Knoll Farm or their agents.  I understand and agree that my e-Signature executed in conjunction with the electronic submission of this form shall be legally binding and such transaction shall be considered authorized by me. **If you decline, a completed entry form with entrant's or guardian’s HAND-WRITTEN signature must be submitted via e-mail.
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Entrant's Signature in Typed First and Last Name (Guardian Must Sign if Entrant is Under 18 Years of Age):
 *
Date Signed: *
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