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Academy 

Tuition

Enrollment

Monthly Tuition for committed Riders is offered at a discount. It is a monthly commitment for a specific class day and time for a single rider. Tuition is based on (4) weeks per month. Any months with a (5th) lesson on the rider’s day may be used as a Makeup for a missed lesson. Other than such months with a 5th week, there is no guarantee for Makeup lessons for rider illness, travel or other activities. “No Shows” or any lesson cancelled without 24 hours notice is considered “Present”. If Instructor cancels, a Makeup class will be offered within 30 days. 30 days notice to jsalem@mindspring.com is required to cancel enrollment in the Tuition program.

Invoices are emailed the last week of the month. We require a Credit Card Authorization to be kept on file.  Payment is due on the 1st of each month. Payment may be made by Cash, Check, Venmo, ACH or Credit Card (3% fee added for Credit Card payments). To avoid the Credit Card fee, pay the Invoice using one of the free methods. Any Invoices not paid by the 1st will be charged to the Credit Card on file and will include the 3% fee. I authorize Patchwork Farm to use the following credit card as a method of payment for Patchwork Farm invoices not paid by cash, personal check, venmo, or bank to bank transfer. 

Patchwork Farm books 30 minutes for Private Classes, 45 minutes for semi private (2 riders) and 1 hour for Group Classes (3-4). Class time will include grooming, tacking and after-care until student can manage without instruction and supervision. Ride time will vary accordingly. Independent riders may arrive 15 minutes early to groom and tack. Riders are placed in groups as soon as they can ride safely and independently.

Lesson time is not extended for tardiness. Students arriving more than 10 minutes late may be asked to observe lesson in lieu of riding.

I have read and understood the Tuition Policies outlined in this Enrollment Form.

First Rider's Name

First Name*

Middle Name

Last Name*

Phone*
First Rider's Date of Birth*
First Rider's Signature*
Second Rider's Name

First Name*

Middle Name

Last Name*
Second Rider's Date of Birth*
Third Rider's Name

First Name*

Middle Name

Last Name*
Third Rider's Date of Birth*
Fourth Rider's Name

First Name*

Middle Name

Last Name*
Fourth Rider's Date of Birth*
Fifth Rider's Name

First Name*

Middle Name

Last Name*
Fifth Rider's Date of Birth*
Sixth Rider's Name

First Name*

Middle Name

Last Name*
Sixth Rider's Date of Birth*
Seventh Rider's Name

First Name*

Middle Name

Last Name*
Seventh Rider's Date of Birth*
Eighth Rider's Name

First Name*

Middle Name

Last Name*
Eighth Rider's Date of Birth*
Ninth Rider's Name

First Name*

Middle Name

Last Name*
Ninth Rider's Date of Birth*
Tenth Rider's Name

First Name*

Middle Name

Last Name*
Tenth Rider's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Rider's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Credit Card Information

Name on Card *

Card Number *

Expiration Date *

Code *

Address if different from above
Additional Information

Any learning issues we should be aware of?
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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