Prospective Participant Tour

Interested in learning more about the services HETRA offers? We offer tours monthly. You will be able to ask the HETRA staff questions, and watch a session in action!

I am interested in participant information (this tour will not contain volunteer information) *

Select The Tour Date You Plan To Attend*

How did you hear about HETRA? *

Your First Name*

Your Last Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Name of individual interested in receiving services.*

Your relationship to individual seeking services.*

Participant's Birthdate*

Date

Participant's Age*

Participant's Weight*

Diagnosis*

How many total people will be attending the tour including yourself? (Maximum 3 people as we can only have so many people per tour if you need to bring more than 3 please email gsmith@hetra.org)*

Liability Release

As a participant and family member at Heartland Equine Therapeutic Riding Academy, I acknowledge the risks and potential for risks of a horseback riding program. However, I feel that the possible benefits to myself and the clients I work with are greater than the risk assumed. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Heartland Equine Therapeutic Riding Academy, its board of directors, instructors, therapists, volunteers, and employees for any and all injuries and/or losses I may sustain while participating Heartland Equine Therapeutic Riding Academy’s program.

WARNING

Under Nebraska Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to sections 25-21,249 to 25-21,253.

By signing below you are consenting to the above statement.

Signature*

Printed Name*

Date*