Join the Lily Creek Farms Waiting List for New Clients
Please fill out the following form to join the waiting list for new clients. Lily Creek Farms is a Therapeutic Riding Center whose mission is to help children and adults with special needs heal mind, body, and spirit through equine assisted activities.

For more information, email info@lilycreekfarms.org or call 419-785-6763.
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Name of Potential Student: *
Birth Date of Potential Student: *
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Height: *
Weight: *
Diagnosis: *
Name of Contact Person (Parent or Guardian): *
Phone Number of Contact Person: *
Email Address of Contact Person:
Availability - select any that apply: *
Morning
Early Afternoon
Mid Afternoon
Evening
Unavailable
Monday
Tuesday
Wednesday
Thursday
Friday
Reason for wanting Therapeutic Riding Lessons: *
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This form was created inside of Lily Creek Farms.