Spring 2023 Riding Lesson Registration Form

Student Registration Form

Fill out the form for registration, please only 1 Student per form.
Student Name*

*First Name*Last Name
Birth Date*

MonthDayYear
Gender
Parent/Guardian Name (if student is under the age of 18)

*First Name*Last Name
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
E-mail*
example@example.com
Mobile Number*
Emergency Number*
Work Number
Which Months are you looking at registering your student for*

MayJune
What days work best for you?*

MondayTuesdayWednesdayThursdaySaturdays (Mornings Only)
Which type of lessons would you prefer?*

Private Lessons (One on One instruction)Semi-Private Lessons (2 Students at a time)Group Lessons (3-5 Students at a time)
What timeframes work best for you? Use other if you need a more specific time frame.*

Mornings (9 to 12pm)Afternoons (12-5pm)Evenings (5-8pm)Other
How many lessons a week would you like?*

12345
What program are you registering for?*

Evaluation Ride needed to determine Riding LevelJunior P'tit Program (Ages 4 to 7, No experience needed)Level 1 (Ages 8 to 17, No experience needed)Level 2 (Ages 8 to 17, Level 1 or equivalent completed)Level 3 (Ages 8 to 17, Level 2 or equivalent completed)Level 4 (Ages 8 to 17, Level 3 or equivalent completed)Adult Level 1 (Ages 18+, No experience needed)Adult Level 2 (Ages 18+, Level 1 or equivalent completed)Adult Level 3 (Ages 18+, Level 2 or equivalent completed)Adult Level 4 (Ages 18+, Level 3 or equivalent completed)
Helmet Requirement - *Under the age of 18, must wear a helmet.*

Yes, I need to rent a helmet.No, I will provide my own equine certified riding helmet.No, I am over the age of 18, and am choosing to ride without one.
Horse Request
If you have previously taken lessons with us - Not guaranteed
Photo Release*
I understand pictures may be taken during classes for the sole use of advertisement for Midnight's Trail.
Additional Comments
Signature*

Clear
There is no option to pay via this invoice. We will review the form, call, and then send out the invoice.
Should be Empty:

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Student Registration Form