HorseSense: Rider Medical Release Form

HorseSense for Special Riders is a therapeutic riding program designed to benefit the riders physically, socially, and emotionally. Safety equipment and specially trained horses and volunteers are used in order to assure the fullest possible protection and greatest personal benefit from the program. Each rider is required to furnish the following medical information before being accepted as a rider.


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Rider (First Name, Last Name) *
Date of birth *
MM
/
DD
/
YYYY
Name of Parent/Guardian *
Address *
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