Horseback Riding Lesson Info Request

*Thank You for Contacting Leg Up Equestrian!*

Contact Info:	*required fields
*Name:
*email:
Address
City
State	__ zip
phone (day)	hm wk cell
phone (night)	hm wk cell

	would you like us to include you on our mailing list? yes no

Student Info:
*Student's Name:	__age:_ ________________________________________________________
If School Age:	Home School Grade School _ : grade:
If College Age:	College ______.: ..Year:
If Adult Rider:	Adult Rider _________________________________________________________
Previous riding exp?	yes no
if yes, please describe briefly.	(previous riding experience):

Availability:
	Please check all available days and times. __________________________________________________________
Lesson Availability Please list all possible options. We will do our best to accommodate your schedule and preferred days & times.	Mondays Tuesdays Wednesdays Thursdays Fridays ------------------------- Saturdays Sundays	*times: 3:45 PM \| 5:15 PM \| after 6:00 PM times: 3:45 PM \| 5:15 PM \| after 6:00 PM times: 3:45 PM \| 5:15 PM \| after 6:00 PM times: 3:45 PM \| 5:15 PM \| after 6:00 PM times: 3:45 PM \| 5:15 PM \| after 6:00 PM ------------------------------------------------------------------------ times: Sat.. mornings \|_ Sat. .afternoons times*: Sun. mornings \|_ Sun. afternoons
Of those options you selected above, which would be your preferred class days/times?	o (preferred days / times):


I am interested in the following programs:	Riding Lessons Pony-Pals™ (ages 4-7) Summer Camps Clinics & Seminars Boarding Leasing Working Student Program School Shows Outside Competition Instructor Training other

Your Questions or Comments?
	Please contact me ASAP! e-Mail phone either *Thank You!*