Forms | Mangold Ranch Versatility

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Call/Text: 716) 201-6229

CLIENT CONTACT FORM

First Name

Last Name

Birth Date

Parent/Guardian if less than 18 years old

Street Address

Street Address Line 2

City

State

Zip

Phone

Email

Consent to receive email or texts from Mangold Ranch

Yes

No

Emergency Contact Name & Relation

Emergency Contact Phone

Allergies?

How did you hear about us?

Additional Information

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Mangold Ranch Versatility

4870 Upper Mountain Rd

Lockport, NY 14094

716-201-6229

(716) 201-6229