Host Clinic Application3 DAY HORSEMANSHIP CLINIC HOST FACILITY QUESTIONNAIRE Name Of Host * First Name Last Name Mailing Address Of Host * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Contact and Facility Information Cell Phone * (###) ### #### Home Phone * (###) ### #### Email * Facility Name * Facility Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Do you own or have signing authority to this facility? * If you do not own this facility, please provide the name and contact of the person or entity who owns this facility. Yes No Owner Name * First Name Last Name Owner Phone * (###) ### #### Owner Email * Arena and Riding Area Information Is there a Covered Indoor Arena? * Yes No Width in Feet * Length in Feet * Is there an Outdoor Arena? * Yes No Width in Feed * Length in Feet * Is there an Outside Riding Area? * Yes No Facility Amenities Number Of Covered Horse Stall For Rent * Cost Of Stall Rental Per Night * $ Number Of RV Hookups Available At Host Facility * Cost Per Night * $ Hookups * Select all that apply Electric Water Sewage None Do You Have A Bunk House Or Accommodations Available At The Clinic Facility? * Yes No If yes, how many people can you accommodate? Cost Per Person Per Night $ List Names of Hotels Near Your Facility * Do You Provide Meals At The Host Facility? * Yes No If yes, cost per person? $ Are There Restaurants Near Your Facility * Yes No Do You Have An Covered Area For CCHC Merchandise Setup/Sales * Power and wifi preferred. Yes No Facility Available Dates For Hosting A Clinic Option 1 * MM DD YYYY Option 2 * MM DD YYYY Option 3 * MM DD YYYY Thank you!
