CPYR Session Request

Session Request Form
Scheduling Day for June opens on May 15th at 9:00am

We work diligently to ensure we can serve as many children and families as possible, so please complete this form anytime after 9:00am on the 15th if you are interested in getting involved with CPYR's Session Program. If we receive more requests than available spots, we will notify you and add you to our back-fill list for the month.

Due to the high number of inquiries we receive for sessions, if you complete this Session Request Form before 9:00am, your session request will automatically get bumped to the bottom of our requests.
The heart of the CPYR Session Program is to provide a safe place for children, families, and horses to experience the hope, healing, and encouragement of Jesus Christ. Sessions are offered for all kids ages 6-18, and consist of 90-minute one-on-one mentorship through a myriad of activities.

Sessions are offered Monday - Thursday at the following times:

March - June 18

1:00-2:30pm, 2:30-4:00pm and 4:00-5:30pm

June 22 - August (*Summer Schedule)

9:30-11:00am, 11:00am-12:30pm, and 4:00-5:30pm

September - October

1:00-2:30pm, 2:30-4:00pm and 4:00-5:30pm
Your Name

First NameLast Name
Your First Name
Your Last Name
Your Email Address
It works best to enter the email address we typically send emails to.
Your Phone Number
Please enter the best # to reach you at. Format: (000) 000-0000.
Your Relationship to Session Participant(s)
If your household includes a second adult, please add their information below:
First Name
Last Name
Number of Children to Schedule
Family Size for Database
Numeric Family Size for Conditional Logic
1) Child's First Name
1) Child's Last Name
1) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 1
Gender:
2) Child's First Name
2) Child's Last Name
2) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 2
Gender
3) Child's First Name
3) Child's Last Name
3) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 3
Gender
4) Child's First Name
4) Child's Last Name
4) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - 4th Date of Birth
Gender
5) Child's First Name
5) Child's Last Name
5) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 5
Gender
6) Child's First Name
6) Child's Last Name
6) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 6
Gender
7) Child's First Name
7) Child's Last Name
7) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 7
Gender
8) Child's First Name
8) Child's Last Name
8) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 8
Gender
9) Child's First Name
9) Child's Last Name
9) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 9
Gender
10) Child's First Name
10) Child's Last Name
10) Child's Date of Birth

MonthDayYear
Session program available for ages 6-18
Depreciated - Date of Birth 10
Gender
Would you like to share information about your family / child(ren) with their session leader(s):
Please share:
i.e. Divorce/Re-marriage, Single-Parent Home, Alcoholism, Physical/Sexual Abuse, Addiction, Death, Chronic Health Issues, Homelessness, Legal Guardianship Change, Foster Care, Adoption, Depression/Anxiety, Lack of Food/Financial Resources.
For liability purposes, I understand that a parent/guardian is required to stay on-site for the full 90-minutes of a session.
Adult's First Name
Adult's Last Name
Phone #:
Organization (if applicable):
Write which organization this adult is affiliated with, if applicable to their relationship with this child.
Schedule Availability

Using the calendar below, please select up to 10 days/times you are available for sessions. The more information you provide, the more likely it is that we will be able to coordinate sessions for your family. Once you've submited your availablity, we will contact you back via email or phone taking the options you've submitted below into account.
How many preferred dates would you like to provide?
The more options you provide the more likely we are to be able to find a time that works.
Total Preferences Provided
First Preference
Second Preference
Third Preference
Fourth Preference
Fifth Preference
Sixth Preference
Seventh Preference
Eighth Preference
Ninth Preference
Tenth Preference
Please include any other details that might be helpful for our scheduling team (such as days/times that you are unavailable, vacation or time away, etc.)
Communication Preferences
Are you new to the CPYR Session Program? (e.g. Never taken part in sessions before OR it's been a few years)
Are you open to scheduling sessions at different times if there are not enough session leaders available to schedule all of your kids at once?
If we are unable to schedule your family/group initially, you will be placed on our waitlist. Please indicate which types of session openings you would like to be notified about.
Would you like to receive your appointment reminders via text or email?
Cell Number for Text Reminders
Please enter a valid phone number.Format: (000) 000-0000.
Network Provider for Cell Phone
Usually Verizon, AT&T, or T-Mobile
Hidden Field, Value Selected for Appointment Reminders
Family Volunteer Opportunities
Regardless of whether you're scheduled for sessions this month or in future months, we would cherish the opportunity to get to know your family through our Volunteer Program. While working side-by-side on a variety of different projects, we have the joy of getting to know one another and learn how we can shoulder with one another in our unique journeys.

Our volunteers range from the youngest of children to the older, wiser folks who are looking for a Christ-centered mission to get involved with! Volunteers are welcome to join us for an hour, a week, weekly, or just as they're able to throughout the year. Volunteering is offered between the hours of 1:00-5:30pm daily (Monday through Thursday) after completing a Volunteer Application and going through an Orientation with our team. For more information, please contact Ann at ahawley@cpyr.org or check the box below.
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