THR - Tecate Horse Rescue

Section 1 of 3: Participant Information and Program Details

Participant / Organization Information

Full Name (Individual/Teacher/Group Leader) *

School / Organization / Program (if applicable)

Phone Number *

Email Address *

Best Way to Contact You *

Phone Email

Section 2 of 3: Program Format and Accessibility

Program Details (continued)

Preferred Program Format *

Day Program

Weekend Intensive

Multi-Week Learning Module

Overnight Tent Camping

Preferred Date(s)* (Select at least one date)

Alternative Date(s)* (Select at least one date)

Number of Participants *

Age Range of Participants *

Accessibility & Support

Transportation Needs * We can provide our own transportation We may need assistance with transportation

Special Needs / Accommodations (Optional)

Section 3 of 3: Payment, Notes and Signature

Payment & Access

Payment Type * School / Organizational Partnership Direct Pay Sliding Scale Request (based on grant availability) Program Referral Funding (city/county/federal) Others

Additional Note Or Questions

Signature

I confirm that the above information is accurate to the best of my knowledge.

Name(Type Full Name) *

Date *

The Herd That Heals Experience

The Camping & Horse Experience

Ranch Academy Program Sign-Up Form