Monthly Complimentary Workshop

Monthly Complimentary Workshop

For those on a cancer journey
Please the date you would like to attend
2024 Dates
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Do you have any medications or health conditions that may interfere with your comfort during the program?

YesNo
If yes, then please share them below:
Please list any dietary restrictions.
Do you have any fears or concerns attending the program or interacting with horses?
Is there anything we need to know to make this the best possible experience for you?
Do you have any previous horse experience? (No experience necessary to participate)
AGREEMENT/REMINDERS:

You are responsible for consulting with your physician and/or therapist to determine your suitability for the workshop. Please sign that you have read this statement and assume responsibility.
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