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CFC
(Combined Federal Campaign)
Code # 65891
SECC
(State Employee
Charitable Campaign)
Code #100501

Therapeutic Horsemanship Program for the Disabled
Ponder, Texas

Rider Registration Information

Please fill out the following forms and submit to be enrolled in the next class schedule. If you need more information please contact Mary Gwinner, Program Director. Please Note**Select all the forms either individually or all together in the zip file and fill them out before turning them in.

Financial Assistance .doc

Zipped file of all the documents needed

Welcome Letter .doc

Info packet overview .doc

Guidelines .doc

Map to the Facility .doc

Rider Application for Summer Classes .doc

Rider Application .doc

Rider Registration & Release Form .doc

Rider's Health History and Goals .doc

Rider's Authorization for Emergency Medical Treatment .doc
(Form to be printed, signed and mailed)

Getting to Know You .doc

Rider's Medical History and Physician's Statement .doc
(Form to be printed, signed and mailed) Information for Physician

Listing of Rider's Medical Conditions to aid Physicians filling out the forms .doc

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