Please read the information and mail only the application form found below along with your waiver/release |
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If a class is full, or is very close to the maximum allowed, the information will be posted here, on the course locations page and the course dates page. If there is no notice, then it should be presumed that there is room in the course. If you have submitted your application on line (made a payment - Visa/MC), please fill out this application form and the waiver/release and send both to the address listed below. You may also scan the form with the most important pages - those being the top page with your name, and the bottom page with your signature. We do not have a fax. You may register for a course within two weeks prior to the course start date-this is not a cut off date. If this is the case, please call me so I can add your name to the list of registrants, and give you the homework information while your application is en route. If the course is to begin in a few days, call me and please fill out this form and bring it with you to the course along with the full course fee-do not mail it as it will reach Ontario after class begins. If you have not registered for a course on line (made a payment with PayPal), please fill out his form and the waiver/release form, and mail both to the address provided below with your deposit. The balance of the course is due on the first day of class payable as: cheque, money order, cash or a print out receipt from PayPal if the balance is paid on line within 48 hours of the course start date. ___________________________________________________________________________________________________ Course Costs: |
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Equine massage therapy courses taught in all provinces that do not have HST: $735.00 ($700 + $35 GST). $135 deposit + $600 balance due on 1st day of class Ontario: $700 + 13% HST - $791 - $191 deposit cheque + $600 balance due on 1st day of class Nova Sotia: $700 + 15% HST - $805 - $205 deposit + $600 balance due on 1st day of class British Columbia: $700 + 12% HST - $784 - $184 deposit cheque + $600 balance due on 1st day of class Any provinces where the course is to be held not listed above that have HST in effect, please add the HST to the deposit. Equine vertbral realignment attendance course taught in all provinces that do not have the HST: $420 ($400 + $20 GST) $120 deposit + $300 balance due on 1st day of class Ontario: $400 + 13% HST - $452 - $152 deposit + $300 balance due on first day of class Nova Sotia : $400 + 15% HST - $460 - $160 deposit + $300 balance due on first day of class British Columbia : $400 + 12% HST - $448 - $148 deposit + $300 balance due on first day of class Advanced massage course only: $315 ($300 + $15 GST) - only available for returning students prior to 2008 graduation or any grads from 2008-2010 that would like to re-take this section. Deposit of $105 + $200 due on first day of class. $100 +HST in applicable provinces (Ontario - HST: $39, Nova Scotia - HST $45, British Columbia- HST: $36) + $200 balance due on 1st day of class The advanced massage course is included in the equine massage course. This is an upgrade only for previous graduates, or for those graduates that would like to re-take this portion of the course (day: 3 from 3:30-5, days 4 & 5 8-5 and day 6 8-12) ______________________________________________________________________________________________ Please note: Cheques are deposited two weeks prior to the course start date regardless of the date on the cheque. There is a $25 fee for any returned cheques. You may cancel prior to two weeks of the course start date, and your cheque will be destroyed or if you have made a payment on line, it will be returned to you via cheque less the PayPal fee (see Cancellation policy). Any cancellations within the two weeks prior to the course start date will result in forfeit of the deposit. Although all courses are presumed to be moving forward, there is a class MINIUMUM of 6 students that must be registered. A final decision regarding a course is made two weeks prior to the course start date. If a class does not have the required number of students, then all students will be contacted, deposit cheques will be destroyed and any deposits via PayPal will be returned via cheque (not as a refund to the credit card) in their entirety. If you do not receive a phone call to inform you of a cancellation, then it is to be presumed that the course is moving forward. Please see the 'cancellation policy' area for the full cancellation policy. Upon receipt of your application, you will receive a either a confirmation call or e-mail indicating that your application has been received. You will be given the pass codes for the on line homework. This is the only phone call you will receive. If you have made a payment on line, you will not receive a phone call as your homework information will be e-mailed to you at the time of your on line payment. The application form is for our files and the waiver is mandatory for all participants _______________________________________________________________________________________________ Please print the 'course locations' page of the course you will be attending for full directions to the facility and any hotel/motel information.Everyone! Please write the following information on the course location page you have printed. Please be at the facility on the first day of class at 7:50am, so class can begin promptly at 8am. Massage classes are from 8-5pm daily. The last day of class will be concluded at noon. Depending on the size of the vertebral realignment class, the times are: day 1: 8-5pm and day 2: 8-3pm The remaining balance of the course is due on the first day of class. Payment is accepted as: cheque, cash, money order, certified cheque or a printed receipt showing the payment has been made on line (if payment has been made 48 hours in advance of the course). We do not have Visa/MC service at the course locations. A receipt will be issued on the last day of class along with my GST/HST # Pack: a lunch, sunscreen, hat, steel toed footware (if you have it), cushion or towel for sitting upon. I provide plastic stools if there are no chairs provided by the facility, and they can get quite uncomfortable. Please also pack gloves in case of cold weather- the dollar store thin gloves are perfect for massaging in cold weather. My cell # (to be used in case of emergency only, i.e. you cannot find the facility) is 1-519-562-9992 --------- I do not answer this phone while I am teaching. Any questions should be directed to either my e-mail (through the 'contact' section of the web site), or please leave a message by dialing the number below. Please print the waiver/release form. It is on the 'application forms' page directly below the link that brought you to this page. Please be sure to have someone witness and date the form. If the form is not done correctly, another must be filled out at the course. If you do not have a witness present, then a form can be filled out at the course. To leave me a message on my answering service call : 1-888-378-4632 (1-888-EQUINE2) web site: www.equinerehab.ca end of necessary information to be written on course location page. ____________________________________________________________________________________ Course dates: Please check your date and post date your cheque: Massage Courses 2010: Langley, BC Aug 31-Sept 05 ............................................. Post date Aug. 17, 2010 _______ Rocky Mt. House, AB Sept 15-20 ..................................... Post date Sept. 01, 2010_______ Saskatoon, SK Sept 21-26 .................................................. Post date Sept 07, 2010 _______ Brandon, MB Sept 27-Oct 02 .............................................Post date Sept 13, 2010 _______ Oakwood (Toronto, ON area) Oct 18-23...........................Post date Oct. 4, 2010 ________ Antigonish, NS Oct 26-31 ................................................... Post date Oct. 12, 2010_______ Vertebral Realignment Attendance Courses 2010 Winnipeg MB, October 3-4 ................................................ Post date Sept 17, 2010 ______ Antigonish, NS Nov. 1-2 ......................................................Post date Oct. 18, 2010 _______ _____________________________________________________________________________________ Please mail only the application form below. You may need to trim this first page to accommodate as each printer varies on how it reads this form. Application Form Please fill out this form and the waiver/release form and mail them to: Sidonia McIntyre: Course location and date: ___________________________________________________Massage course - deposit amount _$_________________ check above for post date ______ Vertebral realignment attendance course - deposit amount _$______________check above for post date ______ Advanced massage only days 3-6 (see above for class times) - deposit amount _$______________ Graduates prior to 2008 or any graduates after 2008 that would like to retake this section - please fill out line below: Original course location and year ____________________________________________________________________ I have made a payment on line ________ Name on credit card if different from the person attending ___________________________________ Please print clearly and neatly as the application form is scanned and e-mailed to me while I am on the road.
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Address: ____________________________________________ |
City: ___________________________________ |
Province: ___________________ |
Postal Code: _______________________ |
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Horse experience (check one please) regarding ground work with horses: I am: very ____ fairly ____ somewhat _____ not at all _____ confident. I have: lots _____ some______ no _____ experience My horses are very respectful and do not push, nudge, try to run over me. This statement is: accurate ____ somewhat accurate ____ not at all accurate _____ N/A ___ Due to a reading/learning disability, I need to take the test in oral rather than in written format (confidential) _________ (only write 'yes' if applicable, otherwise leave blank) How did you find out about this course? magazine (name) _______________________________________________________________ website/google/surfing internet ___________ received a brochure ___________ equine federation website ________ other website link ____________________________ other _____________________________________ Do you belong to a provincial equestrian federation? ________ which one ____________ Do you belong to a riding club? Pony club? etc. _________ Name please: ___________________________________________________________________ ______________________________________________________________________________________________________________ If the applicant is 18 or over, please read and sign. If the applicant is under 18 (at the time of signing), then the parent/guardian must read and also sign. By signing below, I (or the parent/guardian on behalf of the minor) agree that: I have read both the cancellation and refunds policies and agree to the terms and conditions therein. I have read, signed, dated and have witnessed my waiver/release form which is found under the 'application forms' button as a separate document, and have included it in this package to mail, and if it is not included I understand that I must sign and have witnessed a waiver/release if I am to participate in this course. The date for the witness must match the date of the attendee and must appear on the form. If I need to cancel my attendance in the course, I will call and leave a message at: 1-888-378-4632. I understand that it is highly recommended that I wear safety shoes. I understand that as we are working with horses, there is inherent danger in working with them, along with the dangers of working on horse properties, and I take full responsibility for my actions and further agree to follow all safety protocol as outlined in the course. Neither Equanimity (Equinimity) or Sidonia McIntyre take responsibility for any expenses incurred to any registrants should a class be cancelled either before or within the two weeks prior to the course start date. I take full responsibiity for any injury I may incur during this course. Signature ____________________________________________________ Date _______________
Parent/guardian if applicable _____________________________________ Date ______________ |
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