Rider’s Name

Home Tel.#

Cell Tel.#

Work Tel.#

Address

City/State/Zip:

E-Mail:

Parent/Guard.

(Minors)

Tel. #

Emergency Contact:

Relationship

Emergency #

Age Group

College student?

College faculty?

Riding Style

English, Western, Not Sure?

Quarter

Please tell us a little about your riding experience and what your goals may be, if any.

Do you require carpooling assistance from campus?

Are you available to provide transportation from campus to this class for other students in order to share gas expenses?

If yes, we may provide your telephone number to potential student’s who require transportation?

Are you taking the class for credit?

If you plan to ride with a friend, please list the names of those individuals:

Please tell us what times you are available to ride: Monday-Saturday at 8am, 9am, 10am, 11am 12pm, 1pm, 2pm, 3pm, 4pm, 5pm, 6pm, 7pm 8pm or 9pm.

Please note 4, 5, 6, and 7 PM hours are  generally reserved for returning students and public lesson patrons. Please try to include as many other non-prime time options as possible.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Do you have any questions or comments?

By clicking "Submit Query" I acknowledge that I have read and agree to the terms provided in the course Information page which precedes this registration form.  These terms include but are not limited to the Drop, Refund and Attendance Policies which apply to all students registering for a 161 course.