Service Change Request Form
Client
*
First Name
Last Name
Email
*
example@example.com
Rider
*
First Name
Last Name
Horse (if applicable)
Requested Change(s). Please check all that apply and provide details below:
*
Add a new service
Cancel a service (30-day notice required)
Change quantity (for example: amount of feed, frequency of horse training, etc.)
Change service day (for example: move lessons from Monday to Friday)
Other (please describe)
Description of Requested Change(s):
*
Effective Date of Change: (if asap, select today's date)
*
-
Month
-
Day
Year
Date
By signing below, I confirm that I am authorized to request these changes on behalf of the client/account holder.
Signature Name
*
First Name
Last Name
*
I understand and agree with all terms and conditions stated above.
Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: