PONY CLUB SUMMER VACATION REGISTRATION 

WE HAVE BEEN HAVING SOME HOSTING PROBLEMS-IF YOU CANNOT SUBMIT THIS FORM-PLEASE FILL IT OUT, PRINT IT DOWN AND MAIL IT TO THE FARM. THANK YOU

CONTACT INFORMATION

CHILD'S NAME:
 PHONE:
 EMAIL:
  
ADDRESS:
 CITY:
 STATE:
 ZIP:

PROGRAM INFORMATION: July 7th and July 28th filled

PROGRAM TYPE:(ages 6 yrs and older)

EXTENDED AFTERNOON SESS.12:30-4:00

  

 
SESSION-all sessions are considered available unless noted otherwise-please do not call for availability  
 AGE OF CHILD/COMMENTS:  

 PAYMENT INFORMATION-please read carefully: AS OF JUNE 1ST TUITION MUST BE PAID IN FULL
  Final payments can be made by check but must be received on or before MAY 30th. If final payment is not received by may 30th, balances will be charged to your credit card on file  JUNE 1st. DEPOSITS AND TUITION PAYMENTS ARE NON-REFUNDABLE.

I HAVE READ AND ACCEPT PAYMENT POLICIES:AS OF JUNE 1ST TUTITION MUST BE PAID IN FULL  

 

NAME ON CARD:
PAYMENT TYPE:  
CREDIT CARD NUMBER (PLEASE ADD DASHES BETWEEN GROUPS OF NUMBERS):
EXPIRATION DATE:
BILLING ADDRESS:  
SECURITY CODE (back of card):