Academy Enrollment Applicaton | The Black Cowgirl

Registration

Student's First & Last Name

Student's Age

Parent/Guardian's First and Last Name

Parent/Guardian's E-mail

Full Address. Street,City,State,Zip Code

Please list any medical conditions or allergies

Please describe student's experience with horses. It is okay if there is little to no experience.

List available days and times for lessons. We will coordinate to schedule.

Why are you interested in joining the Guardians of Equines Academy?

Emergency Contact Informaton

PHOTO RELEASE FORM FOR MINORS (UNDER 18) I grant permission to Guardians of the Equines to use photographs and/or video of my child to promote their program. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall be payable to me by reason of such use. Required

Yes, I grant permission

No, I do not grant permission

Which program plan are you interested in? Required

$100/month age 3-6 (4 lessons)

$155/month age 7-16 (4 lessons)

I understad all waviers and notices of policies must be signed prior to first lesson.

I understand participation in the academy requires communication and consistency.