Heroes on Horseback

CONTINUING REGISTRATION FORM

SPRING SESSION 2008 – 6 weeks
May 6th through June 14th

Please sign below to indicated your plan to participate in the Six Week Spring 2008
session. Please indicate any information that has changed since the last registration.
Session Fee is $150. Please contact the office if payment arrangements are needed.
Your instructor will be in touch with you to confirm the lesson time.

Participant Name: __________________________________________________

Lesson DAY OF WEEK:______________________

Indicate changes below:

E-Mail Address: Home Phone: Mobile Phone:

Address: City: State / Zip:

Emergency Contact:: Phone: Phone:

Medical Conditions & Medications:

Other :

□ To my knowledge there are no known changes to the participant’s medical conditions,

medications or contact information.

Please reserve my space in the Six Week Spring 2008 Session May 6th – June 14th
SIGNATURE/ DATE: