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Therapeutic Riding Interest Form
This form is for anyone interested in having a child participate in our Therapeutic Riding program.
What is your name?
What is your child's name?
How old is your child?
What is the best number to reach you at?
Why are you seeking out therapeutic riding for your child?
What days/times are best for you
Do you qualify for any of these providers?
Well Care Insurance (MTM)
Child of Someone in the Military
How did you hear about us?
Any other notes?
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