Lesson Enrollment Form You will need get a copy of this, Download & please fill out. Click Here for Lesson Policy Form *Please upload your form to us* (At the Policy page) Step 1 of 10 - Student Enrollment Form 10% Name First Last Email* Cell Phone* I am Enrolling for:*Student 17 yr or youngerAdult 18 yr and upEnrolling Group Lessons*3 Lessons/month2 Lesson/month1 Lesson/monthBeg Level 1- 2 Lesson/monthPackage Group Lessons This is a Monthly Lesson Program agreement - See Lesson Policy for more details. (Must enroll in autopay for monthly program for package price) Group Lessons for Beginner/Intermediate, Intermediate to Advance level Riders (7yr & up) Average time 1hr 15-20 min (tack/groom/care of horses) 3 lessons/month = $192 2 lessons/month = $136 1 lesson/month = $70 Option to add one semi or private for 3x/month (additional fee). Let us know when you want those. ** Enrollment Packages: Payment due 1st of month. Beginner Semi-Private – 7yr & up: $130 2 lessons/month 45 min ** In a group lesson if only one student is able to attend then they will have a 30 minute private lesson. ** Riding Skills Assessment: required for all new riders (Except those who recently have participated at M&M camp) 1 hr. (20 min riding) Package Adult Lessons This is a Monthly Lesson Program agreement - See Lesson Policy for more details. (Must enroll in autopay for monthly program for package price) Adult Lessons for Beginner/Intermediate to Advance level Riders Plan an additional 15 minutes for each lesson to help prepare your horse. Semi-Private: 30 min (tack/groom/care of horses/riding or groundwork) 2 lessons/month = $130 3 lesson/month = $195 Semi-Private: 45 min (tack/groom/care of horses/riding or groundwork) 2 lessons/month = $155 3 lesson/month = $230 Optional: to add a semi or private lesson. Let us know and we will check our availability. ** Enrollment Packages: Payment due 1st of month. ** In a group lesson if only one student is able to attend then they will have a 30 minute private lesson. ** Riding Skills Assessment: required for all new riders (Except those who recently have participated at M&M camp) 1 hr. (20 min riding) Parent/Guardian Name* First Last Student Name First Last Student's Age (Less 17 yr)*67891011121314Student's Age (18 yr+)*18-2425-3435-4445-5455-6465 or AboveStudent Birthday* Date Format: MM slash DD slash YYYY Student Grade*K1st2nd3rd4th5th6th7th8thStudent's Weight (Less 17 yr)*50 - 60 pounds61 - 70 pounds71 - 80 pounds81 - 90 pounds91 - 100 pounds101 - 115 pounds116 - 130 pounds130 - 150 poundsStudent's Weight (18 yr+)*71 - 80 pounds81 - 90 pounds91 - 100 pounds101 - 115 pounds116 - 130 pounds130 - 150 pounds151 - 165 pounds166 - 175 poundsStudent'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 own2nd Phone # Known Allergies*YesNoAllergies*(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*How did you hear about us?*FriendRelativePrevious CamperCamp Advertising SiteSearch on InternetotherWhich website did you hear about us?*Please describe rider's experiences with horses and riding:*If no experience, write "none". Horse Info:Does student currently have own horse?*NoYesPlease check what applies to student's horse.*NoneJust started competing - not faster than trotJust started competing - not faster than lopeJust started competing - able to runCompeted 8+ times local shows - past 12 monthsDo not compete, but interestedCheck any that applies for your horse..* Very good ground manners Walk, Trot and lope no problem Ties well does not set back Well manner for farrier Gets the correct lead Kicks other horses while being ridden Bites other horses while being ridden Bucks when ridden Bucks when not ridden consistently Does not rear Rearing is an issue Medical InformationInsurance Name*Insurance Phone #*Policy Holder's Name* First Last Relation to Student*GrandparentParentFriendOther RelativeGroup ID#*Policy ID#* Medical InformationEmergency Contact Name*(Other than parent listed on enrollment form) First Last Emergency Contact Phone*Relation to Student*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. Specify Other Illness or Chronic Condition:* PoliciesCancellation & Make Up Policy*Cancellation Policy: If taking monthly lessons, one make-up per 9 lessons is allowed and must be taken within 30 days or forfeited. (There are no refunds for missed or being late to lessons.) Please notify us by email (DO NOT TEXT) at least 48 hours prior to cancellation or lesson will be forfeited. 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. Please see M&M Ranch Lesson Policy for rescheduling/make-ups. There is no refund once payment is made. I have read and understand the Payment, Cancellation, Refund Policy Discontinue Lessons Policy*To discontinue lessons, change lesson plan, or need to take a break, WE REQUIRE a 30 DAY WRITTEN NOTICE DATED BEFORE THE FIRST OF THE MONTH. The notice will need to be emailed to M&M Ranch 30 days prior to last month of lessons; lessons paid on the 1st can be ridden out that month. **Example: if you want to discontinue lessons by June, you will need to notify M&M Ranch prior to May 1st, May 1st payment goes through and lessons are ridden out in May.** (Spots are limited, so when you come back for lessons you may be put on the waiting list.) I have read and understand the Discontinue Lesson Policy Please upload your Signed Policy FormM&M Ranch Lesson Policy Agreement and Signature* Yes, I have received a copy of the M&M Ranch Lesson Policy Agreement and Signature Please initial each policy you have recieved. Please make a copy of this form for your own records and scan and email the initialed and signed form. *You can upload your form instead of emailing it. Are you bringing your own horse?*NoYesBringing Your Own Horse Policy*List of Requirements: broke, well behaved, and healthy. Copy of Current Coggin, Vaccines Teeth floated at least within last 8 months Current on feet care & recent exam for any pain. Health Certificate (within 30 days of coming to the Ranch) I have read and understand the requirements of bringing my own horse. PaymentDepositNon-refundable deposit equal to one-month tuition required to start lessons. (Option to pay ½ deposit 1st month, remaining due by 2nd month payment) + Processing Fee Monthly Lesson Fee* Price: $0.00 Deposit Type*Full DepositHalf DepositDeposit and Processing Fee Price: $0.00 Deposit and 3% processing fee Total $0.00 Billing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card Card Details Cardholder Name Important*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 another page. Yes, I understandNameThis field is for validation purposes and should be left unchanged.