Today's Date:

Phone Number:

Name:

Address:

City:

State/Province:

Country:

Emergency Contact:

Energency Contact Number:

Requested Starting Date:

Alternative Starting Date:

Method of Payment: Check Visa Mastercard

Please submit payment to the following address or call your credit card number in within 1 week of registration:

Shur Shod Horseshoeing School
2900 Bluebird Drive
Grovespring MO 65662

TO REGISTER FOR ENROLLMENT

Please submit this completed form and your method of payment ($300.00 - U.S. funds only). The $300.00 Registration fee is non-refundable unless requested sessions are full. The balance of tuition is due on the first day of class, plus $350.00 per week if requesting additional weeks.

By typing my initials here, I acknowledge that I will not hold Shur Shod Horseshoeing School or any of there personnel responsible for any accident whatsoever that I may be involved in while attending school on or off the premises.