Palladia Farm: Riding School Registration

Did You Know...
You can Register Online for Riding School?

Beginner — Sept 11 - Dec 18, 2010, $600
Saturday

Intermediate — Sept 11- Dec 18, 2010, $600
Saturday

Advanced — Sept 12 - Dec 19, 2010, $600
Sunday

Intermediate 2 — Sept 12 - Dec 19, 2010, $600
Sunday

Rider's Name:
Parent's name if rider is under 18:
Address:
City:
State:
Zip Code:
Phone:	Format: 847-555-1212
Email Address:

Birth Date:	(4-digit year)

Height:	Weight:

Name:
Phone 1:	Phone 2: Format: 847-555-1212

Does this rider have any allergies, disabilities, or other medical conditions?
If so, please describe them in the space below.

Does this rider have any learning disabilities or psychological disorders?
Common examples include dyslexia, language problems, ADD, ADHD, anxiety problems, PTSD, and depression. Knowledge of these issues can help us select appropriate horses, set goals, and structure the lessons. If so, please describe them in the space below.

Is there anything else that you would like to share with your instructor before your first ride?

I understand that every student must wear a shoe with a low, square heel, heavy riding pants, and an ASTM/SEI approved riding helmet. These items will NOT be provided by Palladia Farm, Inc. Riders who do not wear these items will not be allowed to ride a horse. No refund will be given to participants who are not appropriately attired.

Full payment is due two weeks before the start of each session. Payments are non-refundable unless we are able to fill your slot with another student. Your space in the Riding School will not be reserved until payment is received.

NO ONE will be allowed to ride or to participate in any of the horsemanship sessions unless there is a signed Liability Waiver on file for that person. For riders under the age of 18, a parent or legal guardian must sign the Liability Waiver. No refund will be given to participants who do not sign a Liability Waiver. View the Liability Waiver in a new window (requires Adobe Acrobat Reader).