Clinic Rebate Form for ICP Instructed Clinics

If you are a member of the Area IV Adult Riders or Young Riders programs, you may be eligible for a clinic rebate.

Requirements:

Clinic must be taught by a USEA ICP instructor
Clinic must be listed on the Area IV website's "Clinics" page and Calendar
Clinic must take place in Area IV
Rider requesting a rebate must be a current Adult Rider or Young Rider member
Rider can only use this form 3 times total, for 3 different clinics

Use this Webform to request a rebate!!

Note: Riders may use this rebate up to 3 times for 3 different clinics. The Area IV council reserves the right to revise this policy at any time at the discretion of the Area Council, based on funds availability.

Name

First Name

Last Name

Email Address

Mailing Address

Name of Clinic and Instructor

Date of the Clinic

YYYY

Message

Are You:

Adult Rider Member

Young Rider Member