Equestrian Gym Class Registration - Lutherlyn Equestrian Center

Please complete this form to register for classes. Please fill out a separate form for each child. Fields marked with a "*" denote a required response.

Parent/Guardian/Primary Contact Information

*REQUIRED
*REQUIRED
*REQUIRED
*REQUIRED

Student Information

*REQUIRED
*REQUIRED

Equestrian Gym Class Session Selection

Payment Information

*REQUIRED
$
*REQUIRED
*REQUIRED
Visa MasterCard Discover
*REQUIRED
/
*REQUIRED
? Visa®, Mastercard®, and Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.
*REQUIRED

Your credit/debit card information will be kept confidential. By submitting this form, you agree to the card listed above being charged. You will receive a confirmation email once your registration has been submitted.

All questions in regard to the cost or other information, please contact Carla, the Equestrian Center Manager at 724-496-5535 or stables@lutherlyn.com.