Lofty Heart Lesson Inquiry and sign up

Lofty Heart Lesson Inquiry and sign up
Riders Name*

First NameLast Name
Parent/Guardian name if under 18

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Years of Riding Experience*

0-12-45+
AGE*

2-45-67-1011-1415-1819+
Riding Discipline Experience (Check All that apply)

English FlatDressageWesternHunter/Jumper CrossrailsHunter/Jumper 2ftHunter/Jumper 2'6" PlusOther
Rider Height*

Under 5ft5'1"-5'4"5'5"-5'8"5'9" and up
Rider Weight*

Under 50 lbs.51-99lbs.100-130lbs.131-170lbs.171-199lbs.Over 200 lbs.
Availability (Check all that apply)*

Monday 4PMMonday 5PMMonday 6PMMonday 7PMTuesday 4PMTuesday 5PMTuesday 6PMTuesday 7PMWednesday 4PMWednesday 5PMWednesday 6PMWednesday 7PMThursday 4PMThursday 5PMThursday 6PMThursday 7PMFriday 4PMFriday 5PMFriday 6PMFriday 7PM
Should be Empty: