Registration for Horseback Riding Lessons
Rider's Name
*
First Name
Last Name
Rider's Age
*
Parent's Name (if under 18)
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Desired Lesson Days (Lessons are open on Thursdays, Fridays, and Sundays and subjected to availability.) Click all that apply:
*
Thursday
Friday
Sunday
Early Morning (7am-9am)
Morning (9am-11am)
Mid-Afternoon (11am-1pm)
Afternoon (1pm-4pm)
Evening (4pm-7pm)
Desired Start Date
*
Lessons Refund Policy...Clients can ask for a refund within 10 days of purchase. Lessons expire 12 months after date of purchase. If client does not show for lesson, or does not communicate at least 24 hours ahead of lesson time, client will be charged for lesson. All refund exceptions will be approved at the discretion of owner only.
*
I understand the Refund policy
Other
Participant Release - Known by all present: The undersigned understands and agrees that there is inherent risk of injury in all equine-related activities, both mounted and non-mounted. It is understood that horses may stumble, bite, run, or make unpredictable movements which may cause a participant to be injured by or fall from the horse. I am willing and able to accept full responsibility for my own safety and welfare and my family’s. I do hereby release and discharge Al’s Horse Academy, it’s instructors, staff, volunteers and horse owners from any and all responsibility or liability to me, my child, or my family in connection with any injuries or disease suffered by me, my child, or my family as a result of my activity, participation and attendance involving Al’s Horse Academy horses/ponies, property or events.
*
I agree to the Participant Release for my child, myself and/or my family.
Other
Photo Release - I hereby grant Al’s Horse Academy and all entities permission to use any and all photographs, slides and any other audio visual materials in which I may appear for the express purpose of promoting Al’s Horse Academy programs and I do not expect, nor shall I receive any monetary reimbursement for this authorization.
*
I agree to the Photo Release
I disagree to the Photo Release
Medical Information for Participant - Please let us know below if participant has any medical or allergy conditions we need to know about. This includes ADHD, Autism, allergic to anything, etc. This will help our staff keep all riders safe. If medication is needed please give it to Management with name clearly printed with directions for application. For participants who develop allergies while at Academy, the participants' affected area will be washed. Then the Academy will contact the parent/guardian for further instructions. If Academy is administering medication per your permission, and the participant is exhibiting allergy symptoms including, but not limited to: facial swelling, other excessive swelling or trouble breathing, or if another emergency occurs which Management believes requires a 9111 call, Academy will call 911 before contacting the parent/guardian. The parent/guardian accepts full medical financial responsibility for the participant.
*
The participant has a medical condition described below
The participant has an allergy condition described below
The participant is healthy, with no medical or allergy conditions
Other
Medical or Allergy Conditions
Emergency Contact - if other than parent information above
First Name
Last Name
Emergency Contact Phone Number - if other than parent information above
Please enter a valid phone number.
How will you pay? *Payment must be complete prior to Lessons being added to the calendar*
*
by Credit Card below
By Check
By Cash
Other
My Products
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Horseback Riding Lesson - First Lesson
All riders, All Ages, First Lesson is the same price.
$
50.00
Quantity
1
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10
Item subtotal:
$
0.00
Horseback Riding Lesson - 4 pack per rider
$
180.00
Quantity
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3
4
5
6
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8
9
10
Horseback Riding Lesson - 8 pack per rider
$
320.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
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