New Student Form You will need get a copy of this, Download & please fill out. Click Here for Waiver Form *You can upload your form to us* (last page) 2*-Lesson-intro Step 1 of 6 16% Reservation For*Student 17 yr or youngerAdult 18 yr and upName Adult Student* First Last Name Parent/Guardian* First Last Email* Cell Phone*Person filling out this form?*ParentLegal GuardianOtherName-for other* First Last How Related to Student? Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student Name* First Last Student's Age (Youth)*67891011121314151617Age-Adult*18192021222324252627282930313233-3535+Student Grade*K1st2nd3rd4th5th6th7th8th9th10th11thStudent's Age (18 yr+) Adult*18-2122-2526-3435-4445-5455-6465 or AboveStudent's Weight (18 yr+) Adult*50 - 60 pounds61 - 70 pounds71 - 80 pounds81 - 90 pounds91 - 100 pounds101 - 110 pounds111 - 120 pounds121-130 pounds131 - 140 pounds150+ poundsFor safety and health of our horses we need to know this. Student's Weight (Adult) 150+*151-160 pounds161-170 pounds181-190 pounds191-200 pounds201+ pounds210+ pounds220+ pounds230+ poundsFor safety and health of our horses we need to know this. Student Birthday* MM slash DD slash YYYY Student's Weight (Youth)*50 - 60 pounds61 - 70 pounds71 - 80 pounds81 - 90 pounds91 - 100 pounds101 - 115 pounds116 - 130 pounds130 - 150 pounds+150 poundsStudent's Weight (Youth) 150+*151-160 pounds161-170 pounds181-190 pounds190-201 pounds201+ poundsFor safety and health of our horses we need to know this. Student's Height*3'8" - 3'11"4' - 4'4"4'5" - 4'7"4'8" - 4'11"5' - 5'3"5'4" - 5'7"5'8" - 6'6' or morePrevious Riding Experience*None0-5 hours (walk only)5-20 hours (walk only)5-20 hours (walk,trot)20+ Rider able trot, lope on their ownCurrently taking Lessons 2-4 times/month, trot, lope on their ownNot taking lessons ride 3-4 times/month, trot, lope on their ownPlease describe rider's experiences with horses and riding:*If no experience, write "none". Medical InformationKnown Allergies* Yes No Allergies*(check all that apply): Animals Insect Stings Medications Food Hay Fever/Pollen Plants Other Other/Specify Allergies:* Known Medical Conditions that could affect student's riding* Specify Other Illness or Chronic Condition:* Important Safety Information*Horseback riding is a very physical outdoor recreational activity. For student safety and the safety of others, participants must meet certain physical requirements to take lessons at M&M Ranch. Our lessons are designed for our students to ride in groups. Students must be in good physical shape and not have any conditions that may affect their ability to participate in all aspects of lessons and horse care. These include but are not limited to items such as arthritis, excessive weight, back or neck pain, decreased motor skills or other physical issues that may contribute to a difficulty balancing, staying seated, holding the reins or controlling a horse. Students must be able to mount and dismount a horse without assistance (Instructors will help younger students). Students must be able to meet the rigors of riding, including dismounting the horse without stirrups. Students must have the ability to independently remain seated and balanced on a horse in motion while simultaneously directing a horse's travel and speed for at least 1-2 hours. Students must be able to withstand all seasons of exposure to the outdoors, including hot, cold and or wet weather for a period of 1-2 hours. For the safety of all students, we do not offer services for special needs riders. We recommend that you visit R.O.C.K. - Ride On Center for Kids which specializes in special needs riders. We are not set up to have one on one instruction with riders who have special physical or emotional limitations. Thank You! I have read and understand the Important Safety Information on attending riding lessons at M&M Ranch. How did you hear about us?*FriendRelativePrevious CamperCamp Advertising SiteSearch on InternetotherPerson you heard from?* Which website did you hear about us?* Emergency ContactEmergency Contact Name*(Other than parent/guardian/person listed on enrollment form) First Last Emergency Contact Phone*Relation to Student* Lesson PolicyAre you bringing your own horse?*NoYesBringing Your Own Horse Policy*List of Requirements: broke, well behaved, and healthy. Copy of Current Coggin Teeth check within last 6-8 months (Float if needed) Current on feet care & recent exam for any pain. I have read and understand the requirements of bringing my own horse. Riding Requirements* Each rider must have a signed Liability Release Form to ride. Long pants (Blue jeans recommended) and closed in shoes required, boots preferred.. Yes I read and understand Waiver Form* Yes, I have received a copy of the M&M Ranch Waiver Form *You can upload your form here instead of emailing it. Please upload your Signed Waiver Policy FormMax. file size: 64 MB.Cancellation Policy*We do not refund once payment is made for any reason. Please notify us by email (DO NOT TEXT) at least 48 hours prior to cancellation or lesson will be forfeited. Scheduled make-up lessons must be taken within 30 days or if missed will be forfeited. In the event a rider does not attend/cancels their make-up lesson, the lesson is forfeited and is ineligible for rescheduling. Monthly Program-One make-up lesson per 9 lessons allowed. If M&M Ranch determines that a lesson will need to be rescheduled, then we will schedule a make-up day. (There are no refunds for missed or being late for lessons.) Monthly Lessons We do not do make-up for bad weather days, since we provide a barn lesson. If M&M ranch determines that the lesson will need to be cancelled, then we will schedule a make-up day. I have read and understand the Payment, Cancellation, Refund Policy PaymentEnrolling For*Intro LessonIntro Lesson with HorseLesson Payment* Price: Process Fee* Price: $0.00 Coupon Total $0.00 Credit CardCard Details Cardholder Name IMPORANT*Submitting your enrollment may take a few moments. Don't refresh or close the page after you make your payment. After you make the payment it will take you to our website. Yes, understand PhoneThis field is for validation purposes and should be left unchanged.