Place check mark next to clinic and complete registration information below:

• Please provide the following contact information:

  (Note:  We do not provide information to third parties)

  Name
  Organization/Farm Name
  City
  State/Province
  Zip/Postal Code
  Phone  #
  FAX
  E-mail
  Number of Attendees	Adults
  	Children

Comments:  Estimated arrival time, any special needs or questions

Other Classes or events you would like to see us host this year