Fix-a-Test with Cheryl Ash
This form is to be used to register to "Ride" in the Fix-a-Test with Cheryl Ash

June 29, 2019

Stemmler Stein Equine
510 Orchard Lane
Orwigsburg, Pa
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  • I understand that upon clicking the Submit button I am obligated to submit payment via the payment method chosen in the payment options section below.

    I also understand that I am required to bring a current copy of a Negative Coggins Test and EHV-1 Vaccination to the clinic or I will not be able to ride in the clinic.
  • Please choose the Payment Option you prefer to use below:
  • Note:
    After clicking the submit button (only click once) wait several seconds for the payment screen to appear (be patient it will appear).
    In the payment screen you have two options:
    1. Use your PayPal account by loggin into your PayPal account(this is the choice at the top)
    2. Click on the button at lower portion of screen labeled "Pay with Debit/Credit Card" to use your card and enter you card information
  • Note:
    When you choose Pay by Check and hit submit the payment check out screen will still appear after a few seconds. Simply exit out of that screen without continuing any further.
    Before hitting submit write down this address to send your check to:
    Jen Koch, 2225 Seipstown Rd., Fogelsville, Pa