Fall 2022 Wait list, One on One Session Application
Use this form only if you want to sign a child up for a one on one Fall sessions.
* Session participants must be age 5 to 18
* Submitting this application does not guarantee your child is accepted for the program. You will be contacted for days and times that are available
* Sessions are 60 minutes in length (or shorter depending on the child's needs). This time will include grooming, helping with a  chore, and riding
* Parent or legal guardian must remain on site during the session time
* Child should bring a bottle of water or refillable cup
* Child should apply sunscreen when coming to the ranch and bring extra with them
* Long pants are suggested.
* Child must wear sturdy, closed toe/closed heel shoes. Crocs or sandals are unacceptable
* A hat for sun protection is suggested. A riding helmet will be provided and must be worn for safety
* Additional information and a liability form must be completed and at the ranch prior to beginning of session time
** A suggested  donation of $35.00 per session **
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Email *
Your Child's First and Last Name *
Gender *
Birth date of child. *
Parent or Legal Guardian First and Last Name *
This person will be the primary contact person
Please provide your Email Address *
For confirmation and updates
Please provide your Phone Number *
Best number to reach you      format 111-11-1111
Please provide your mailing address *
Please include City, State and Zip Code
Has your child had One on One Sessions at the ranch before? *
Which day is your first choice *
Which Goup is your first choice *
What emotional/mental issues does your child struggle with? *
Answer in less than 10 words please. Further details can be provided later.
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