Virtual lesson application form

1
Your Name* This field is required.
First Name
Last Name
2
E-mail* This field is required.
3
Phone Number* This field is required.Mobile preferred
(0400) 111 222
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Country and State you live in (so that we know your time zone)* This field is required.
5
Are there any updates on your horse / horse training that you would like Mark to know about in preparation for your lesson? Something in particular you are struggling with or want to achieve?not required
6
Preferred method of lesson* This field is required.Please select one
Zoom - which has the option of sending through a recording of the lesson
Skype
FaceTime
Pivo
I just want a phone conversation
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Would you like to have your recorded lesson sent to you?* This field is required.Additional charge $10
YESNO
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Risk Warning and Waiver Agreement* This field is required.
9
Disclaimer of Liability* This field is required.
I understand that the advice that Mark Langley may provide for my feedback is for general information purposes only. I understand that I should not rely solely on the advice given for making my decisions. I understand that whilst Mark Langley tries to make the advice relevant he makes no representations or warranties of any kind, express or inclined about the completeness, accuracy, reliability, or suitability with respect to the information or products contained for any purposes. I understand that any reliance I place on such material is therefore strictly at my own risk.
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Privacy Policy Acceptance* This field is required.
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Please pay for 1 lesson now - option 2 enables you to order the recording alsoYour other lessons for 2024 will be invoiced separately, with each due 1 week prior
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ORDER SUMMARY
Charge includes GST. AUD
SubtotalAUD
Total costAUD
1 hour virtual tuition/ conference (GST will be added)Personal Virtual Private Lesson with Mark Langley (GST will be added)
$127.27AUDEdit
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Quantity
Recording of Lesson (Zoom or Pivo only)GST will be added
$9.09AUDEdit
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Total cost $0.00AUD
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Payment Methods
Debit Or Credit Card
Select PayPal Method
Please click one of the PayPal options to complete payment and submit the form.
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