Stable Moments Enrollment Application

Stable Moments is an Equine Assisted Learning mentorship program that matches

1 community mentor, with

1 foster or adopted child and

1 horse for

1 hour per week to develop life skills for healthy transitions into adulthood.

This program will run August - May. Please note there may be a waiting list.

If you’re interested, please complete the form below to initiate the enrollment process. Our Program director will reach out to schedule an Intake Assessment. During this assessment, we’ll conduct an interview to assess whether the child is a good fit for our program. We’ll then discuss a personalized care plan. Following that, we’ll handle the necessary paperwork and address financial commitments.  Before the child can begin the first session, a simple pre-test (life skills assessment) must be completed be the parent online to give us a reference point of where the child is currently.

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Date of application *
MM
/
DD
/
YYYY
Is the child in/or has been in Foster/Kinship Care, Adopted and or experienced Complex Trauma? Choose all that apply. *
Required
First and Last Name of Child
 *
Age of Child 
 *
Date of Birth
 *
MM
/
DD
/
YYYY
Male or Female *
Address: Street, City, State, Zip
Cell Phone *
Email *
Preferred contact method
What is the greatest challenge/goal you hope to address? You may consider the following areas:
learning/knowledge
emotional and/or behavioral
community participation
independent living (responsibility, habits)
job training (relating to self-sufficiency or employment)
recreational opportunities
*
Your answer

 *
Indicate strengths and interests.
 *
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