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Sign Up to Ride in the 2026 Western Dressage Cindy Butler Clinic
"
*
" indicates required fields
Rider Name
*
First
Last
Rider E-mail
*
Rider Phone
*
Rider Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
JYR/AA/PRO
*
Junior-Young Rider
Adult Amateur
Professional
Rider IDS Member
*
Yes
No
Rider USDF and/or WDAA Number
Horse Name
*
Negative Coggins is required
Horse Gender
*
Mare
Gelding
Stallion
Owner Name
*
Owner Email
*
Owner Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Western Level Training
*
Intro
Basic
Level 1
Level 2
Level 3
Level 4
Level 5
Western Level Shown
*
Not Shown Yet
Intro
Basic
Level 1
Level 2
Level 3
Level 4
Level 5
Classical Level Training/Shown
if applicable
Show History
If applicable, please provide a short history of this horse's show history. You can include level showing, highest score, median score, or whatever you think is relevant for our clinician.
Clinic Riding Fee
*
Both Days $300.00
Saturday Only $150.00
Sunday Only $150.00
Stabling
*
Haul In One Day $10.00
Haul In Two Days $20.00
Stabling Saturday Night Only $20.00
Stabling Friday and Saturday Nights $40.00
Lunch
*
No Lunch Needed
Lunch Both Days $30.00
Lunch Saturday Only $15.00
Lunch Sunday Only $15.00
Consent
*
I understand this fee is non-refundable.
Should the clinic be oversubscribed, you will be notified that you are on the wait list. IDS will refund wait-listed submissions that do not get the opportunity to participate.
Liability Waiver
*
I understand and accept the liability waiver below.
I elect voluntarily to participate in this activity in any capacity or as the parent/guardian of a minor participant. I recognize and accept the inherent risks involved in equine related activities and agree to hold harmless the clinicians, organizers, officials, staff, other participants, landowners and their respective affiliate organizations from any liability of any kind or nature for injury or damage which may befall me or my property while traveling to, from or during the designated activity at whatever facility or on whatever property may be utilized for the purpose of this activity. I recognize that I am responsible and liable for any damages or injury caused by my own negligence or as a result of any action of any animal I bring to the activity. I further recognize that this release shall be binding upon my heirs, executors, successors, trustees, and assigns.
Note: A separate liability waiver may be required by the hosting facility.
Total
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