Therapeutic Riding Interest List

Parent/Guardian name *

Primary Contact Email Address *

Primary Contact Cell Phone Number *

Rider's name *

Rider's age and Diagnosis *

Is rider a client of The Regional Center? *

Yes

No

I understand that the wait time for a potential riding spot is at least 2 years *

yes

No

Are you able to pay full tuition out of pocket? ($1200 annually/ $400 per trimester) *

Yes

No

If you are interested in mental health sessions, please contact the office 760-731-9168