ENROLLMENT
APPLICATION
Application is hereby made for the understanding on terms described below: I understand that the school may accept or reject the application without notice or explanation.
Name
Address
City StateZip
email
Phone Home
Phone Work
Date of birth (xx/xx/xx)
Place of birth
US Citizen
Age
Height
Sex
Physical Defects
TETANUS SHOT REQUIRED!
In Case of emergency, notify:
Phone
Medical Ins
If under 21 both parents must sign:
Date
PLEASE USE ANOTHER SHEET OF PAPER FOR ADDITIONAL INFORMATION AND (SNAIL) MAIL IT TO US! Education: Years/Name and Address of School/Field of Study
High School
Trade School
College
Horse Experience
NO EXPERIENCE NECESSARY!
Employer
Enrollment fee $100.00 with application non-refundable. I affirm that all information given in this application is true to the best of my knowledge. I will assume and accept all responsibility for any accident or injury which I may suffer during the time of enrollment, as well as any compensation time. I further release and discharge LOOKOUT MOUNTAIN SCHOOL OF HORSESHOEING, its owners, instructors, horse owners, and any landowner in which a class or training is taking place, in all suits, actions, and all causes of act, under the terms herein set forth. Class Date
Check one of the following;
2 week course
OR 8 week course_______ Any questions, call Lookout Mountain at: (256) 546-2036 or email Tom at tmcnew@microxl.com
