Page 1 of 2 PMC Registration form for Workshop Participants, CanTRA Exam candidates, Auditors (Spectators) and Volunteers October 3rd, 4th and 5th, 2014 Location: Gait Equestrian Centre, Moose Jaw, Sask. (map of driving directions available on the PMC website: www.pmcsask.com) Everyone planning to participate in the Instructor mentoring workshop must have a current 2014 CanTRA or Saskatchewan Horse Federation membership. Volunteers are not required to have memberships, but do need to have CRIMINAL RECORD CHECK DONE PRIOR TO THE EXAMINATION WEEKEND. (SEE page 2 for volunteer information) We also welcome auditors (spectators) for the mentoring workshop on Friday, October 3rd (only). PLEASE NOTE: No spectators are allowed to be present during the examinations on October 4th & 5th, except the volunteers and riders who are needed to help for the examinations. Name: ____________________________________________________________________________ Address: ______________________________________ City/town: _________________________________ Province: ______________________ Postal Code: _______________________ Email: ___________________________________________________ Telephone: (_____) ________ -_____________ other: ____________ (_____) ________-_______________ Please list any food allergies: ___________________________________________________________________ I will be attending as a: CTRAI / CTRII / CTRI / CanTRA Coach / AUDITOR (spectator) / VOLUNTEER ( Please circle) Please CHECK the days you would like to attend: _____ Friday, October 3rd, 2014 (PMC Instructor mentoring workshop) – as a participant, spectator or volunteer (Please circle) _____ Saturday, October 4th (CanTRA Examination day) CanTRA exam candidate or volunteer (Please circle) _____ Sunday, October 5th (CanTRA Examination day) CanTRA exam candidate or volunteer (Please circle) Page 2 of 2 PAYMENT INFORMATION This form requesting payment is only for attending the Instructor mentoring workshop on October 3rd, 2014. CanTRA examination fee information is obtained by contacting your CanTRA Education Coordinator – Nanci Picken email: [email protected] Payment must be sent with application and registration forms must be received by September 15th, 2014 (POSTDATED CHEQUES ARE ACCEPTED) Please make cheque or money order payable to: Prairie Mentoring Centre for Therapeutic Riding Inc. (PMC) 50 Langley Street, Regina, Sask. S4S 3V6 Participant for workshop on October 3rd, 2014 Auditor (spectator) for workshop on October 3rd - $ 75.00 (1 day) with lunch & refreshments - $ 40.00 (1 day) with lunch & refreshments Volunteer - No charge for any of the 3 days. Lunch and refreshments are included in exchange for the donation of your time and effort in helping us make this weekend a success! NOTE FOR VOLUNTEERS Please circle ( YES or NO ) if you have a valid criminal record check. This check is required for everyone 14 years of age and older who will be assisting in the Saturday & Sunday examinations. We will be having some awesome riders with disabilities join us on Saturday & Sunday. A criminal record check is easily obtained from your local Police Station and there is no charge from the police station if you indicate that you will be volunteering. Print and take this form with you and return with confirmation to us that you have had the criminal record check completed.