| Referred By: |
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Student:
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Helmet Needed (Yes or No):
(Required)
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| Camp Horse Needed? (Yes, No): |
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| Birthdate: |
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Height (If Camp Horse Needed)
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| Weight (If Camp Horse Needed)
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Level of Riding
(1) None
(2) Very Little
(3) Ride Train Horse in Control at Walk, Trot
(4) Ride Train Horse in Control at W/T/Canter
(5) Ride Green Horse in Control at W/T/Canter
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Briefly Describe Riding Experience:
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Briefly Describe Handling Experience:
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Name
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Address
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| City: |
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State
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Zipcode:
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| Phone: |
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| Best Time To Call: |
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Email:
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If Bringing Horse, Date of Coggins
(Up-to-Date Coggins Required)
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