Equine-imity Somatic Wellness Program @Aisling Ridge
This is the registration form for both the Youth (ages 12 - 18) and Adult (19+) Equine-imity Somatic Wellness Programs.  Please complete one registration form per participant.  Registration is a 2 step process; no payment is due at the time of filling out this form (step 1).  We will contact you via email once your registration information has been reviewed and then you will receive an invoice for the program.  Please Note the following before submitting this form:

1.  Registration is only complete once step 2 is complete and payment is received.  
2.  Participants must wear closed toed shoes or boots and dress appropriately for the weather/temperature.
3.  A waiver of liability must be signed prior to 1st session.  These are available for download from our website or can be signed at the farm.
4.  Sessions may be cancelled by Aisling Ridge for any reason, such as inclement weather, in which case cancelled sessions will be rescheduled at the sole discretion of Aisling Ridge.
5.  Fees are non-refundable.  
6.  Participants must be under 200lbs and be physically able-bodied.
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Email *
Participant's Name *
Date of Birth *
Participants 12-18 years old are placed in the Youth Program, those aged 19+ are placed in the Adult Program.
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Parent/Guardian's Name (if under 18)
Address *
Home Phone
Cell Phone
Email address for invoice
If you would like your invoice sent to a different email address.
Alternate Emergency Contact *
Phone *
Health Card #
How did you find out about our program? *
Additional Information *
Please tell us about what brings you to our program, including any current or past health issues or illnesses, special needs, past traumas and future goals
*I give Aisling Ridge permission to take pictures of participant *
*I give Aisling Ridge permission to use pictures of participant in advertising, marketing materials, website, Facebook page, etc. *
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