Program Interest Form

Thank you for your interest in Saddle Up!. We do currently have a waitlist for Adaptive Riding and Therapy services. This form will put your child on that list. Adaptive Riding offers provisional riding spots to children available Monday-Friday from 9am to 3:30pm. The waitlist is waiting for evenings and Saturdays. During the summer, any time is open to our waitlist children. Therapy services are only available on weekdays during the day. There are no after school or Saturday therapies. Once you fill out this form, you will receive our new participant packet by email. Please return all paperwork and call to schedule an assessment for your child.

Parent Information

Parent First Name

Parent Last Name

Address Line 1

City

State

Postal Code

Phone

How did you hear about the program?

Participant Information

Child's Name

LAST, FIRST

Date of Birth

Primary Disability

Gender

Height

Weight

* Therapy Appointments (Speech, PT and OT) require a physician's referral and are only available during school hours. The cost is $120 per 45 minute session private pay (medically coded invoices provided.)

Contact Information