1-Student Enrollment - M&M Horse Ranch

Name*
First Last
Email*
Cell Phone*

Parent/Guardian Name*
First Last
Student Name (18 yr+)*
First Last
Student Name (Youth)*
First Last

Student's Age (Less 17 yr)*
Student's Age (18 yr+)*
Student Birthday*
MM slash DD slash YYYY
Student Grade*
Student's Weight (Less 17 yr)*
Student's Weight (18 yr+)*
Student's Height*
Previous Riding Experience*
2nd Phone #*

Known 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*
How did you hear about us?*
Which website did you hear about us?*
Please describe rider's experiences with horses and riding:*
If no experience, write "none".

Medical Information
Insurance Name*
Insurance Phone #*
Policy Holder's Name*
First Last
Relation to Student*
Group ID#*
Policy ID#*

Medical Information
Emergency 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:*

Policies
Cancellation & 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 1^st 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 1^st, May 1^st 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 Form
Max. file size: 128 MB.
M&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.
Payment for lesson due 1st of Month-late fee will be applied*
- Yes, I read and understand Late Fee Policy
Payments not received by the 1st of month will incur a $25.00 late fee and the fee will continue to increase at $10.00 per week thereafter. Monthly lesson payment must be made prior student arrival to lesson.
Hidden
Are you bringing your own horse?*
Hidden
Bringing 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.

Payment
Deposit
Non-refundable deposit equal to one-month tuition required to start lessons. (Option to pay ½ deposit 1^st month, remaining due by 2^nd month payment)
+ Processing Fee
Monthly Lesson Fee*
Price:
Deposit Type*
Deposit and Processing Fee
Price: $0.00
Deposit and processing fee
Total
$0.00
Billing Address*
Street Address City 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 understand
Comments
This field is for validation purposes and should be left unchanged.

Lesson Enrollment Form

Step 1 of 10

Horse Info:

Medical Information

Medical Information

Policies

Payment

Deposit