Rider Master Form

Here is our information form for all riders. You can download a .pdf of the form, or fill out our online form below.


Rider Master Contact Form

MM slash DD slash YYYY
Name of Rider(Required)
Name of Parent or Guardian ( If Applicable )
Physical Address(Required)
Mailing Address(Required)

About the Rider

Has rider participated in the STRIDE program before?(Required)
Can rider sit upright for an extended period without assistance?(Required)
*For the safety of both our riders and volunteers, riders weighing more than 50 pounds who cannot sit in an upright position without assistance are not eligible to participate in STRIDE classes.
Does the rider require special accommodations?(Required)

Riders may register for one six-week set of riding classes per session. The rider’s fee for the 2023 session is $450 per session.

Who is responsible for payment?(Required)

Please make checks payable to STRIDE.

Please keep in mind when signing up and selecting a session that classes, except for the summer session, will be held during the school year. Will you be available during the day and will you/the rider be able to participate after a full day of school and/or therapy? This year we are requesting that each rider bring 2 of their own volunteers- we will provide all necessary training. We gladly accept parents/caregivers as volunteers!
Sessions will be determined as we get enough riders to form a class (minimum of three riders per class). You will be notified of the days and times as the sessions are established. We will do our best to give you plenty of advance notice so you can schedule accordingly!

Release of Liability

I have read and signed the rider release form provided by STRIDE. If I am a minor, my parent or guardian has read and signed the release form.(Required)

Photographic Release

Note: The following must be acknowledged by all volunteers or by the parents or guardians of volunteers who are less than 18 years of age.

I hereby give Southcentral Therapeutic Riding, Inc. (d/b/a STRIDE) the right and permission to publish, without charge or compensation, photographs of the rider taken in connection with his/her participation in activities sponsored or conducted by STRIDE. These pictures may be used only for purposes of promoting STRIDE and its equine assisted riding activities and may be disseminated through publication, audio-visual presentation, the Internet, promotional literature and advertising and may be subjected to digital manipulation. STRIDE will not reassign or sell the images covered by this release without further written permission from the person named above, or from his/her parent or guardian in the event he/she is under eighteen (18) years of age or is otherwise not legally competent to enter into contracts.

Consent to above statement(Required)

Policy of Confidentiality

Confidentiality is defined as “told in secret or private relations; trusted.” Any information in regards to the participants (clients) at STRIDE must be held in strict confidentiality. It is critical that we respect each individual. Confidentiality is considered one of the most basic responsibilities of our facility. Failure to abide by this policy may diminish the quality of the services we provide and result in legal ramifications. I have read and understand STRIDE’s Policy of Confidentiality and agree to abide by it.

I affirm that I have read and understand the above Policy of Confidentiality(Required)

By submitting this form below, you are acknowledging you are a legal representative for the rider, and that your answers are comlpete and true to the best of your knowledge, and that any and all agreements are legally binding.