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Foothills Farm | Contact Information
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Rider Information
Rider's Name
*
Your answer
Parent or Legal Guardian Name of Junior Rider
*Required if rider is under the age of 18*
Your answer
Address: Street Name and Number
*
Your answer
City
*
Your answer
Postal Code
*
Your answer
Primary Phone Number (Home/Mobile/Work)
*main source of contact*
*
Your answer
Email
*
Your answer
Do you have any Medical Conditions (Allergies, etc)?
*
Yes
No
If answered "Yes", what are they?
Your answer
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