Thank you for your interest in our equine activities. Please complete this form to the best of your ability so we can best match you with the most suitable program.
First Name
Last Name
Date of Birth
Phone Number
Email Address
Emergency Contact Name
Emergency Contact Phone
Street Address
City
State/Province
Postal/Zip Code
Have you ever worked with or ridden horses before?
If yes, please describe your experience (e.g., riding lessons, trail riding, competitions, etc.)
How often do you interact with horses?
Never
Occasionally
Monthly
Weekly
Daily
What is your comfort level around horses?
Very comfortable
Somewhat comfortable
Neutral
Somewhat uncomfortable
Very uncomfortable
Have you ever owned or cared for a horse?
Do you have any formal equine training or certifications?
If yes, please specify.
Key Considerations | Yes or No | If yes, please specify. | ||
|---|---|---|---|---|
A | B | C | ||
1 | Do you have any physical limitations or medical conditions that may affect your ability to participate in equine activities? | |||
2 | Are you allergic to horses, hay, dust, or other barn-related allergens? | |||
3 | Do you have any recent injuries or surgeries that may impact your participation? | |||
4 | Do you require any special accommodations to participate? |
What type of equine activity are you interested in?
Riding Lessons
Trail Riding
Horseback camping
Competitive riding (e.g., dressage, jumping, barrel racing)
Groundwork and horsemanship
Therapeutic riding
Other:
What is your primary goal for participating in this activity?
Recreation
Skill development
Competition
Therapy or emotional support
Other:
What is your preferred level of intensity for the activity?
Beginner (no experience)
Intermediate (some experience)
Advanced (experienced rider)
Are you comfortable working with horses of different temperaments?
Do you have any fears or concerns about working with horses?
Key Considerations | Yes or No | ||
|---|---|---|---|
A | B | ||
1 | Do you understand the risks involved in equine activities? | ||
2 | Are you willing to follow all safety instructions and guidelines provided by the instructor or facility? | ||
3 | Do you have insurance that covers equine-related activities? | ||
4 | Will you wear appropriate safety gear (e.g., helmet, boots) during the activity? |
Is there anything else you would like us to know about your experience, goals, or concerns?
How did you hear about this equine activity?
Friend or family
Social media
Website
Advertisement
Other:
By signing below, I acknowledge that I have provided accurate information and understand the risks associated with equine activities. I agree to follow all safety guidelines and instructions provided by the instructor or facility.
Participant Signature
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