Toggle navigation
About
About
Events
Meet the Crew
Staff and Board Members
Our Services
Our Services
HorsePowered Programs
Stable Relationships
Herd Relationships
Volunteer
Register
Register
Group Event Registration
Individual/Private Registration
Team-Building Activities
Scholarships
Registration Payment
Contact
Donate
Individual/Private Registration
Home
Individual/Private Registration
Parent/Guardian Information
Name*
Phone*
Email*
Receive email updates
Street Address*
City*
State*
Make a Selection
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Participant Information
Name*
Gender*
Male
Female
Birthday
Age
Grade
T-Shirt Size
Make a selection
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does the child have an Individual Education Plan? If so, what kind?
Please list any current allergies, medications, and/or medical conditions that LyonHeart Equine Assisted Learning needs to be aware of.
What other concerns (behavioral, emotional and/or academically ) do you have?
Program Information
Select a Program
Make a selection
HorsePowered Math
HorsePowered Reading
HorsePowered Life Skills
Parenting from the Barn
Psychotherapy
Scholarship
I am applying for a scholarship and have or will submit a scholarship application form
Minor Participant Consent
I, the parent/legal guardian, give my authorization for LyonHeart Equine Assisted Learning to provide services for the above minor and any emergency medical services.
Where did you hear about us?
This site is protected by reCAPTCHA and the Google
Privacy Policy
and
Terms of Service
apply.