Equine and Parenting Coaching Registration – Dallas Parent & Family Coaching
Thank you for your interest in our Equine and Parenting Coaching Sessions. Please complete the form below to reserve your child's spot. For equine sessions, please note that sessions involve safe groundwork with horses such as brushing and leading. Children will not be riding horses.
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
What services are you interested in?
*
Parent Coaching (Classes)
Equine Coaching (Horse Sessions)
Both
Child Full Name
*
First Name
Last Name
Client Age
*
(Actual age, number only)
Please share any behavioral, emotional, or sensory considerations that would help us support your child and ensure a safe experience (e.g., anxiety, impulsivity, difficulty with transitions, etc.)
*
Please include any applicable neurodevelopment disabilities.
Please list any medical conditions or allergies (including animal, environmental, or food-related)
*
If you selected, "Other" above, please share here:
Emergency Contact Full Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Relationship to Child
*
Equine Only
My child will be participating in groundwork activities only (brushing and leading horses). I understand that children will not be riding horses during this session. Initial here:
Sessions are held in Southlake, Texas. Exact location details will be provided after scheduling.
I consent to receive text messages for scheduling and communication purposes. I understand SMS is not a secure method of communication.
Yes
No
Liability Waiver (Placeholder)
Parent / Guardian Signature
Please confirm that you are the legal guardian and you agree to the terms.
Yes, I agree.
Continue
Continue
Should be Empty: