New Rider Registration & Release Form

Therapeutic Riding:

Therapeutic horseback riding is a unique combination of sport, recreation, and education. There are many benefits to therapeutic riding for individuals with physical, cognitive or psychological disabilities. 

Program Fees:

Lessons are $40 for the one hour session we provide. All sessions vary in how many weeks they run, from 6 weeks to 12 weeks. Scholarships are available for riders that may need financial assistance. Please contact us for more information!

How to become a rider:

In order to become a rider please fill out the needed paperwork down below. We only have the "New Rider and Release" form online, with the Medical Form and Pre Screen paperwork that needs to be printed off and sent in. Please send both forms to P.O. Box 906 La Crosse, WI 54602. Leave NO spaces blank. If you are having trouble downloading those forms, please contact us. 

1. New Rider Release and Application

2. Medical Release

3. Pre-Screen Form 

You must first complete and submit the following form down below. (Or you can print off and send in the paper copy) 

Also, new riders must fill out the Pre-Screening form. The pre-screening form asks general questions about the rider. This helps the insturctors gage where each rider is individually before the actual screening process.

Once we have recieved ALL of the forms listed above, a staff member will contact you to confirm and set up a screen. This is chance for the rider to come out and see the farm and meet the instructor. In all, the screen lasts anywhere from 15-40 minutes, depedning upon the rider. Our usual format is quick tour, go over screening questions with parents/guardians/care staff and then get on a ride for a little bit. Once the screen is over, the staff will evaluate if they think our program is a safe and fun activity for the rider. If yes, we will get them scheduled right away! If no, we will discuss what other options there may be. 

Emergency Information
Insurance Information

In order to best serve the riders, this portion must be completed fully!

Please wait until after the screening for scheduling.  Please use this schedule as a reference.

Spring Session 2019
1234
Mondays 3:00PM - 4:00PM
Tuesdays 4:00PM - 5:00PM
Wednesdays 3:00PM - 4:00PM
Thursdays 4:00PM - 5:00PM
1234
Mondays 4:00PM - 5:00PM
Mondays 5:00PM - 6:00PM
Mondays 6:00PM - 7:00PM
Tuesdays 5:00PM - 6:00PM
Tuesdays 6:00PM - 7:00PM
Tuesdays 7:00PM - 8:00PM
Wednesdays 4:00PM - 5:00PM
Wednesdays 5:00PM - 6:00PM
Wednesdays 6:00PM - 7:00PM
Thursdays 5:00PM - 6:00PM
Thursdays 6:00PM - 7:00PM
Thursdays 7:00PM - 8:00PM
Summer Session 2018
1234
Mondays 3:00PM - 4:00PM
Tuesdays 4:00PM - 5:00PM
Wednesdays 3:00PM - 4:00PM
Thursdays 4:00PM - 5:00PM
1234
Mondays 4:00PM - 5:00PM
Mondays 5:00PM - 6:00PM
Mondays 6:00PM - 7:00PM
Tuesdays 5:00PM - 6:00PM
Tuesdays 6:00PM - 7:00PM
Tuesdays 7:00PM - 8:00PM
Wednesdays 4:00PM - 5:00PM
Wednesdays 5:00PM - 6:00PM
Wednesdays 6:00PM - 7:00PM
Thursdays 5:00PM - 6:00PM
Thursdays 6:00PM - 7:00PM
Thursdays 7:00PM - 8:00PM
Fall Session 2018
1234
Mondays 3:00PM - 4:00PM
Tuesdays 4:00PM - 5:00PM
Wednesdays 3:00PM - 4:00PM
Thursdays 4:00PM - 5:00PM
1234
Mondays 4:00PM - 5:00PM
Mondays 5:00PM - 6:00PM
Mondays 6:00PM - 7:00PM
Tuesdays 5:00PM - 6:00PM
Tuesdays 6:00PM - 7:00PM
Tuesdays 7:00PM - 8:00PM
Wednesdays 4:00PM - 5:00PM
Wednesdays 5:00PM - 6:00PM
Wednesdays 6:00PM - 7:00PM
Thursdays 5:00PM - 6:00PM
Thursdays 6:00PM - 7:00PM
Thursdays 7:00PM - 8:00PM

BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, FULLY UNDERSTAND, AND AGREE TO BE BOUND BY THE PROVISIONS OF THIS REGISTRATION & RELEASE (SEE BELOW).

PLEASE NOTE THE FOLLOWING
** All new riders are required to attend a New Rider Screening to ensure a safe and enjoyable experience with our program. Once accepted into the program, you will be registered for a specific session.

*By submitting this form, I hereby request permission for the above named applicant (hereafter referred to as the "Participant") to participate In HorseSense for Special Riders.
*I represent and warrant to you that the Participant is physically and mentally able to participate in HorseSense for Special Riders.
*I acknowledge that the Participant will be using Facilities at his or her own risk.
*I specifically grant permission to you to use the likeness, voice and words of the Participant in television, radio, films, newspapers, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purposes and activities of HorseSense for Special Riders.
*I hereby authorize HorseSense for Special Riders to take such measures and arrange for such medical and hospital treatment as may be deemed advisable for the health and well-being of the Participant in the event the Participant becomes ill or injured at any HorseSense for Special Riders activity and no responsible adult authorized to act on the Participant's behalf is immediately available to be consulted as to appropriate medical care for the Participant.
* In consideration of receiving permission from HorseSense for Special Riders, Inc. ("Sub lessee"), Red Horse Heights (collectively the "Stable") to enter on the premises of the Stable located at W4102 Ober Rd, Coon Valley, Wisconsin, the receipt of which permission is acknowledged, and in consideration of receiving permission to participate in any activities sponsored by or on the premises of the Stable, or to use or otherwise obtain any services or goods offered or sold by, or on the premises of the Stable, the receipt of such permission being also acknowledged, each of the undersigned, individually and on behalf of the undersigned's family, guests and invitees, releases the Stable, its owners, officers, agents, servants and employees of and from any and all liability, claims, demands, actions and causes of action whatsoever, arising out or relating to any loss, damage or injury, including death, that may be sustained by any or each of the undersigned and the undersigned's family, guests and invitees or any property of each of the undersigned and the undersigned's family, guests and invitees while in or on the premises of the Stable, or any premises leased to, owned by, sanctioned by, or under the control or supervision of the Stable, or in route to or from any of the premises.
*Each of the undersigned, individually and on behalf of the undersigned's family, guests and invitees, being aware of the risks and hazards inherent entering on the premises of the Stable or participating in any activities on or around horses, elects voluntarily to enter on the premises of the Stable, knowing their present condition and knowing that their condition may become hazardous and dangerous during the time that each of the undersigned and the undersigned's family, guests and invitees is on the premises of the Stable. Each of the undersigned, individually and on behalf of the undersigned's family, guests and invitees, voluntarily assumes all risks of loss, damage or injury, including death, that may be sustained by any or each of the undersigned and the undersigned's family, guests and invitees while in or on the premises.
*This release is binding on the undersigned and the undersigned's family, guests and invitees, and their respective heirs, executors, administrators, personal representatives and assigns. In signing this release, each of the undersigned acknowledges and represents that he or she: (1) Has read the foregoing release, understands it and signs it voluntarily; (2) Is 18 years of age or older and of sound mind; (3) Is not an agent, servant or employee of the Stable; (4) Has authority to sign this Release for the undersigned's family, guests and invitees; (5) Will indemnify and hold harmless the Stable for any and all costs and expenses, including attorney's fees arising out of any matters released hereunder.

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