Pony Program Sign Up

PONY PROGRAM

Summer Sign Up

9 Memory Lane Farm

Pony Program Sign-Up

Pony Program Sign-Up

2024 Summer Sessions
9 Memory Lane Farm

2024 Pony Program Schedule
Child’s Name
Child's Name
First
Last
Address
Address
City
State/Province
Zip/Postal
ft. in.
Riding Experience?
Own or Lease a Horse / Pony
Please list and describe any physical limitations / conditions which might limit or affect your participation in horse riding activities. Please give full details including but not limited to; Asthma, Back Problems, Diabetes, and Migraines:
ACKNOWLEDGMENT OF RISKS, ACCEPTANCE OF RESPONSIBILTY, AND WAIVER OF CLAIMS I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself / my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my / my child’s participation in the handling of horses and/or horseback riding and waive any and all claims which may result therefrom. I recognize that the risk of serious injury is increased by not wearing certified helmet while horseback riding. I agree to wear a certified protective helmet all times and understand that ALL students are required to wear Certified helmets any time mounted on a horse. I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the entire period of my participation in handling of horses and / or taking of horseback riding lessons upon the premises of Memory Lane Farm, LLC. / Jessica Owen-Smith  shall not be liable and under direction of Memory Lane Farm, LLC on off-site locations.
Payment
Payment