Please provide the following contact information:

Rider's Name-First	Last
Parent/Guardian Name-First	Last
Street Address
Address (cont.)
City
State
Zip Code
Work Phone
Home Phone
Cell phone
E-mail
Session preference-first choice	Please select one Saturday 9:30 am Saturday 10:30 Saturday 11:30 Wednesday 5:30 Wednesday 6:30
Session preference-second choice	Please select one Saturday 9:30 am Saturday 10:30 Saturday 11:30 Wednesday 5:30 Wednesday 6:30
Please contact me by	Please select one e-mail home phone cell phone
Comments or questions