Annie's Answer Weekly Programs

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Programs will be held at Annie's Answer *new* facility - we now have indoor and outdoor riding arenas, climate controlled classrooms, and other exciting facilities not offered elsewhere!

Please fill out information for ONE student only. Additional students require their own form.

Email *

Your student's name *

Your student's age & date of birth: *

Who referred you?/How did you find out about Annie's Answer programs? *

Annie's Answer focuses on developing & strengthening the following "Core Skills." Please select all Core Skills that you're interested in your student developing or strengthening. *

Self-Regulation

Communication

Problem Solving

Responsibility

Courage

Resiliency

Trust

Respect

Connection

Leadership

Confidence

Teamwork

Required

Please select all Equine Assisted Learning & Equine Assisted Therapy programs of interest:

*mounted = riding or sitting on horses

*non-mounted = no riding or sitting on horses

Horsemanship = strengthening core skills through partnership with horses in ground based challenges (non-mounted)

Farm Management = strengthening core skills through partnership with (human) teammates & mentors in caring for animals and farm (non-mounted)

Equine Assisted Music Therapy = combining the power of horses & music to strengthen core skills (mounted & non-mounted options available)

Therapeutic Riding for physical therapy or occupational therapy goals (mounted)

Therapeutic Riding for mental health or social/emotional goals (mounted)

Riding Lessons = strengthening core skills while developing traditional riding skills (mounted)

Required

Please select all program sizes of interest: *

solo = individual/private session with 1 student only.

family/friend group = you have your own group already made up

small group = 2-4 students (your student will be placed with other students seeking same).

large group = 5-10 students (this is for horsemanship/non-mounted activities) your student will be placed with other students seeking same.

Required

Select all that describe your student. This will place your students in the proper levels of programming. *

little or no experience around horses

can ride with side support (either 1 or 2 adults on either side of mounted student; separate adult leading horse).

can independently lead a horse (walking on ground, horse in hand, steering, stopping horse & maintaining safe distance from others)

can ride confidently and balance on horse without controlling horse (pony rides, riding on horse with adult))

can ride independently at a walk, but still working on steering & stopping if nervous, needs to gain confidence. Needs nearby assistance for safety

can ride independently & confidently at a walk - can steer, stop horse, avoid obstacles

can ride independently at a trot - gaining confidence at trot, working on steering, stopping, avoiding obstacles at the trot.

can ride independently & confidently at a trot - can steer, stop horse, avoid obstacles at a trot

can ride independently at a canter - gaining confidence at canter, working on steering, stopping, avoiding obstacles at the canter.

can ride independently & confidently at a canter - can steer, stop horse, avoid obstacles at a canter

Required

We believe consistency is the key to success for students!

We offer programs in 8 week long "terms" and require families to commit to the program at their scheduled day/time for the full 8 weeks. This ensures students get the full benefit of our program & that the time commitment is not overwhelming for any family's schedule.

You can register for as many back-to-back terms as you wish (or take time off), and this allows you to change your student's program, or their day/time of program at the natural break every 8 weeks.

I agree to bring my student each week, for the term of 8 weeks, so that they are set up for the best success possible!

Required

Please tell us about your student's schedule/availability for programs. For each program, students attend once per week at a consistently scheduled day/time.

What days/times are best for your family? What days/times are absolutely unavailable? Which term are you applying for (fall term 1 or 2)?

*we cannot guarantee to accommodate any schedule, but we do our best to work with families' schedules.

Fall Term 1: September 11- November 5

Fall Term 2: November 6 - December 18 (1 week gap for thanksgiving holiday)

Would your family require financial assistance/scholarships to allow your student to participate?

Prices range $50-75 per 50 min session.

*discounts available for students enrolled in multiple programs

No, my family is able to pay the cost without scholarships

No, my family is able to pay the cost without scholarships, but would require a discount or scholarship for multiple programs or multiple students

Yes, my family would require 50% or more of costs covered by scholarships

Yes, my family would require 80% or more of costs covered by scholarships

Required

Are you (or another adult or teenager) interested in volunteering?

*note: you CAN have your children volunteer with you (babies in carriers, pre-teen, teens, etc.)

I (or another adult or teenager) am interested in volunteering

I (or another adult or teenager) am interested in volunteering, in order to achieve a discount for my student.

I am not interested in volunteering

Required

Does your student have any of the following diagnosis? Select all that apply, and provide details on next question. *

phyiscal disability

intellectual and/or developmental disability

learning disability

behavioral disorder

mental health diagnosis

history of trauma

no diagnosis, but displays symptoms or needs support

no diagnosis

Required

Please list all diagnosis, any symptoms, or support your student needs *

Is there any other information you'd like to share about your student, or any accommodations you'd like to discuss? *

What goals do you have for your student? Please be as specific as possible. Include therapeutic, social, and personal goals. *

Please list all medication your student takes during the school year, and list all allergies. *

Your student's t-shirt size *

Your student's pant size: *

Your student's shoe size:

*C=children; Y=youth; W = women; M=men

Student's Weight:

*required for riding programs only. (list program name if not applicable)

Student's Height:

*required for riding programs only. (list program name if not applicable)

Fees & Balance:

You must pay your student's required $50 deposit before their place can be held/their sessions scheduled. (you can apply for scholarship to reduce deposit amount, if needed).

The tuition price per session ranges $50-75, depending on program & size. Tuition must be paid on day of session or in advance. Discounts will be applied automatically if you pay in advance or register for multiple programs, etc. (you can apply for scholarship to reduce tuition amount and/or apply for payment plans to spread out tuition payments).

(select both boxes below to show your understanding):

I understand that if i do not pay the required deposit amount, my student is not guaranteed a place in their program.

I understand that if I do not pay the required tuition on time (at each session or in advance) and do not make arrangements ahead of time with Annie's Answer staff, that my student will not be able to participate in their program.

Required

Annie's Answer Programs are located at our *new* facility at 1366 Keene South Elkhorn Road, Nicholasville, KY 40356.

Transportation is not provided, but we try to connect families interested in carpooling.

My student has transportation, and we are not interested in carpooling information

My student has transportation, and we are interested in carpooling information.

My student does not have reliable transportation and would need transportation to and/or from program (*cannot be guaranteed)

I would be interested in providing transportation along my route to a student in need, in exchange for discounted fees for my student

Required

Custodian Name *

Custodian Phone Number *

Custodian email *

Custodian/student address: *

A copy of your responses will be emailed to the address you provided.

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