Regional Activity Registration Form
Use this form to register for Regional Preps, Camps and Activities
Please complete the answers to each question
Current Horse Management Certification Level
Current Mounted Certification Level
Please indicate date, location, discipline and certification level of intended testings in 2019
Intended 2020 Testings
Deposits will be accepted until February 15, 2019. This $50.00 deposit reduces your overall activity cost to the amounts listed below. You will need to include a $50 deposit for Each activity that is eligible for the early-bird rate that you sign up for. If you will be taking advantage of this opportunity please select below.
Check all that apply
Mounted Prep $175 April 4-5th st, Woodbrook Stable, Lakewood, WA Registration closes 3/15/20
Mounted Prep $175 June 20-21st, Whidbey Island, WA Registration closes 3/15/20
Sign up after February 15, 2020.
Check all that apply.
Mounted Prep $225 April 4th-5th, Woodbrook Stables, Lakewood reg. Reg closed 3/1/2020
Standards and Certifications No Cost, February 29th
HB Un-Mounted Prep $65 June 19th, Meadowgate, Stanwood, WA Registration closes 6/1/20
Mounted Prep $225 June 20-21st, Whidbey Island, WA Registration closes 6/1/20
Please submit earlybird deposits along with the Earlybird form which can be found on the regional website Forms page. Send all payments Regular Mail with your check payable to USPC Northwest Region, C/O Michele Moser 9024 105th Ave NE Lake Stevens, WA 98258
go to PayPal button that is located on the prep's calendar date on the NW region website
$50 Deposit is not refundable or transferable at any time. If you cancel 30 prior to the start date, then you will receive all money paid expect the $50 deposit with a Dr. or vet note.
Please complete the information below for overnight activities
Camping (If applicable)
Stabling if Mounted Activity
Complete Chaperone Information for all activities
Please complete the information below as this is where all information will go thru.
Contact Phone Number
Person completing this form
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