top of page
Home
Services
Equine Activites
Breath & Movement...Christ-centered yoga
Events
Retreat
Giving Page
About
Our Equine Team
Our Team
Our Story
Contact
Minor Release and Waiver
Release and Waiver
Homeschool Class Registration
Scholarship Application
Pre-session Questionnaire BBEA-Coaching
BBEAP Registration
More
Use tab to navigate through the menu items.
Peaceful Pastures Biblically-based
Equine Assisted Learning Programs
Registration Form
Participant Information
Full Name
*
Birthday
*
Month
Month
Day
Year
Gender
*
Phone
*
Address
*
Email
*
Emergency contact name, number, and relationship.
*
Please list any medical conditions and/or allergies. (this includes environmental and food)
Does you have any prior experiences with horses?
Do you authorize Peaceful Pastures to use and reproduce any and all photographs and adiovisual material taken of the participant and family members while in individual and/or group sessions for use in the promotion of Peaceful Pastures.
*
Signature
*
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Date
*
Month
Month
Day
Year
Submit
bottom of page
