Please print, fill out, and mail to
Cindi Scoleri, 13512 Alta Mesa Road,
Galt, CA, 95632. If you have questions, call (209) 748-2658
| Child's Name |
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| Child's Age and Grade Entering |
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| Parent(s) Name(s) |
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| Street Address |
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| City, Zip |
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| Home Phone |
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| Cell Phone |
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| Work Phone |
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| Emergency Contact Name and Phone |
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Does your child have any riding experience? If so, please describe:
Does your child have any difficulties with academics? If so, please describe:
Which session(s) do you want your child to attend?
Please include a $150 deposit with this form, or pay by PayPal to allisonacres@yahoo.com. Thank you!