Kelly Maddox Training, Inc. Rider Information
First Name: *
Last Name: *
Parent/Guardian Name (if a minor):
Age: *
E-mail: *
Phone Number:
Riding Experience *
Any Special Needs? (Including Allergies) *	Yes No
If Yes, Please Explain:
Which Week Would You Like To Attend? *
Will You Be Using Your Own Horse? *	Yes No, I will be needing one of yours
How did you hear about us?
Anything you want to add?

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