Focus on Riding Registration

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November 6-7, 2008 Schedule of Events *Required *Full Name (last, first, middle)

*Address 1

Address 2

*City

*State

< please choose > Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington State West Virginia Wisconsin Wyoming AA/Military AE/Military AP/Military VI/Military

*Zip Code

*Email Address

*Telephone Number

*High School

*Year of Graduation

Ethnicity Please select up to two choices per category. Press the CTRL button to make multiple selections.

please choose... African-American, Black Alaskan, Native American Asian-American, Asian Latina, Hispanic White, Anglo, Caucasian Other

Please list any special dietary needs. (e.g. vegetarian, allergies, etc.)

*Will you be staying overnight?:

Yes   No

*Do you have your parent's / guardian's consent to attend Focus on Riding? Required

Yes         No

In order to stay overnight at Mount Holyoke, you must bring your signed (by your parent/guardian and yourself) Waiver of Liability/Visitation Policy form with you to registration. You may download a copy.

Are you:

Junior Senior

Do you ride dressage?

Yes   No

Do you ride hunter seat?

Yes   No

Additional Comments: