Online Clinic Registration Form

CLINIC AND MOCK RIDE ARE POSTPONED

For your convenience, you can register for the distance ride clinic using this form below. If you are registering more than one person, please submit a form for each attendee. Be sure to also download a flyer.

Cost (per person)

$20 in advance or $25 at the door.

Juniors 16 & Under are Free.

MnDRA members are $10 in advance. $15 at the door.

Lunch and beverages are included.

Payments Accepted:

Checks (Make payable to Peggy Pasillas; checks held until day of clinic)

Mail checks to:

Peggy Pasillas
9928 Rich Valley Blvd
Inver Grove Heights, MN 55077

Paypal (Link to pay: paypal.me/peggypasillas Please do not check the "Goods and Services" link. Include a note indicating you are paying the clinic fee)j. Or you can enter her paypal address directly: peggy@pasillas.net

Questions?

Contact Peggy: Peggy@pasillas.net 651-353-7959 (evenings)

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Clinic Registration Form

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Full Name: *

E-mail address: *

Phone: *

I am a MnDRA member ($10/$15)

I am a Junior, aged 16 and under. (Free)

I am neither a MnDRA member or a Junior ($20/$25)

I will pay via check in advance.

I will pay via paypal in advance.

I will pay via cash or check at the door.

*

I understand my registration to the clinic is not complete until payment is received by Peggy, either through check by mail or paypal. If payment has not arrived as of the clinic date, I understand I will need to pay at the door and any pending payment will be refunded to me.

Note: Fields marked with * are required