Participant Inquiry

New Participant Inquiry

I am interested in learning more about*

TODAY'S DATE

I am interested in (please select all that apply)

Therapeutic horseback riding Horse-assisted learning Using my DDD budget After-school program

I am interested in (please select all that apply)

School group programs (6-12 weeks) Single field trip Staff development/team-building

How did you hear about Pony Power?*

Name*

First Name

Last Name

Phone*

Email*

Preferred method of communication?*

Phone call Text Email

Prospective participant's name (*Please enter First and Last Name)*

First Name

Last Name

Participant's Date of Birth*

Name of school/organization*