Tiny Tot Registration Form

Participant Information

First name

Last name

Does the participant have any allergies? Is an Epi-pen required? Please list all necessary.

Does the participant have any medical issues? Medication?

Does the participant have any known learning and of physical limitations? Please list:

Anything else we should know?

Do you give permission to have pictures and videos posted to our website and social media pages?

Yes

Guardian Information

First & Last Name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Policies

Payment policy – Payment is due upon registration of Program.*

Yes

Lost or stolen policy – Clarity Equine will NOT be held responsible for any lost or stolen items.

Yes

WAIVERS are mandatory. These MUST be completed to participate. Please make sure the participant/guardian has filled out the correct waiver (which can be picked up) or emailed)*

Yes

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