Heartland Therapeutic Riding - 2020 Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

General Info
Who do we contact for scheduling, form completion, etc.?
If you need a different week than your age group is assigned, please contact us at info@htrmail.org and we will see what we can do.
Emergency Information
Who do we contact in the event Guardian is unavailable?
Diagnosis and Medical History
If your child has do diagnosis, select "Typically developing - No Diagnosis"
Seizure Information (skip this section if the participant does not have a history of seizures)