Lesson Registration
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Parent Name 

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Parent Email
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Parent Phone Number
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Rider Name
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Rider Age
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Mailing Address
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Riding Experience
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Charter School
Charter School Voucher or Purchase Order
For your students safety, do they have any medical conditions that would effect their ability to ride or follow directions?
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DO YOU AGREE TO BEING CHARGED A DEPOSIT FOR NO SHOWS OR CANCELING LESS THAN 24HR NOTICE *
Required

Proper clothing should be worn for your protection: Long Pants (no shorts or capris), Long or Short sleeved shirt (no tank tops, tubes, spaghetti straps, sleeveless, etc) and Sturdy Hard Soled shoes or Boots.
Bring a water bottle if warm outside, helmets will be provided by the stables, but you can bring your own if you have one.


I hereby release Pipe Dreams Farm, Susan Wilcox; and any other stable employees of responsibility for any injuries or accidents incurred while I or any of my family members or friends are on the premises, riding or otherwise. I further understand that I enter the premises at my own risk and will not hold liable any of the aforementioned named.

It is understood that this is a potentially dangerous sport and although the Instructors will do everything in their power to prevent harm, accidents can and do happen and Pipe Dreams Farm will not be held liable for any occurrences.\

Helmets are required at all times while working around a horse, from the ground or while riding, and will be provided by Pipe Dreams Farm if student does not have their own.

LESSONS ARE RESERVED ON A WEEKLY BASIS AND MUST BE PAID FOR IN ADVANCE

CANCELLATIONS less than 24 hours in advance will be charged for a lesson/deposit. The only exception is if Pipe Dreams Farm staff cancels a lesson due to bad weather.

PLEASE MAKE CHECKS PAYABLE TO:    SUSAN WILCOX
Venmo: Susan-Wilcox-17

I have read and understand the statements above and agree to adhere to all of them.

Signature of Guardian required to sign if student is under the age of 18. Parents must be present the entire time.




STABLE ADDRESS & DIRECTIONS:
2691 Rio Oso Road, Rio Oso, CA   95674     Take Highway 70 to the Kempton Road Exit - EAST
To 4th Avenue - turn RIGHT;           To: Rio Oso Road (post office) Turn RIGHT           To:  2691 on the Right
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