New Student Enrollment 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) Step 1 of 4 - Overnight Camp Enrollment Form 25% Parent/Guardian Name* First Last Cell Phone*Email* Student Name* First Last Student Birthday* Date Format: MM slash DD slash YYYY Student's Age*567891011121314Student Grade*K1st2nd3rd4th5th6th7th8thPrevious 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 #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 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". Emergency ContactEmergency Contact Name*(Other than parent listed on enrollment form) First Last Emergency Contact Phone*Relation to Student*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. PaymentI am enrolling for:*Intro Lesson1 Group Lesson2 lessons monthIntro Lesson (First time): $65 Beginner I Semi-Private – 7yr & up: $130 2 lessons/month 45 min 1 Group Lesson: $70 each no minimum required; payment due when scheduled. Payment must be made online prior to arriving for lessons. Intro Riding Skills Assessment: required for all new riders (Except those who recently have participated at M&M camp) 1 hr. (20 min riding) ** In a group lesson if only one student is able to attend then they will have a 30 minute private lesson. ** Beginner-Semi Private- 7yr up:*Beg 2/month Full DepBeg 2/Month 1/2 DepRemaining BalanceIf you need make payment for an item or past balance due you can enter it here. If you are doing the deposit for enrollment your balance for the deposit will be added to first month payment for year round program. 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. Are you currently enrolled as a student in the Year Round Program at M&M Ranch? Yes No If you are not on our Year Round Program check no. 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 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 Policy FormTotal $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 NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.