Pony Pals Enrollment

Cost: $250.00 for a 4-week session
Please Select the dates and times that you wish to enroll:*
- June 1, 8, 15 & 22 - 5:00PM - 6:00PM
- June 1, 8, 15 & 22 - 6:30PM - 7:30PM
- July 6, 13, 20 & 27 - 5:00PM - 6:00PM
- July 6, 13, 20 & 27 - 6:30PM - 7:30PM
- August 3, 10, 17 & 24 - 5:00PM - 6:00PM
- August 3, 10, 17 & 24 - 6:30PM - 7:30PM
Child Name:*
Age:
Address:*
Street Address Address Line 2 City State ZIP Code
Email:*
Accident/Medical Insurance #:*
Parent/Guardian Name:*
Home Phone:*
Work Phone:
Parent/Guardian Name:
Home Phone:
Work Phone:
In Emergency, Contact:*
Emergency Contact Phone:*
In case of an emergency, we will use the WVU hospital unless otherwise specified here.
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