Thank you for your interest in InStride’s Riding Academy!

For more than 25 years, InStride has provided equine assisted activities and therapies to people with disabilities and others in our community who benefit from working with our horses. InStride has long been recognized as one of the leading equine therapy providers in the Southeastern United States upholding the highest safety and quality standards set forth by the Professional Association of Therapeutic Horsemanship International (PATH).

InStride’s Riding Academy blends our knowledge of therapeutic horsemanship and equine assisted learning with traditional riding instruction. Lessons are well-rounded and include learning about equine behavior, horse care, ground handling, and riding. The goal of each lesson is to help our students develop solid horsemanship skills and an understanding of how these skills translate to critical life skills.

What can you learn from a horse?

Working with and riding horses has many benefits for both children and adults. Aside from the obvious physical benefits, handling, riding, and caring for horses also helps develop critical life skills such as responsibility, patience, emotional awareness, empathy, accountability, confidence, and self-discipline. Developing a healthy partnership with a horse requires us to become good leaders, recognize and establish healthy boundaries, and communicate clearly. The traits needed to develop good horsemanship skills translate well into the classroom, work environment, and daily living.

Our Lesson Program

Lessons are taught by qualified instructors with many years of experience instructing at all levels. Our horses are well-trained, safe, and versatile. Students can choose from English or western lessons with an intentional focus on recreational or competitive riding. Riders must be at least 7 years of age. Discounts on pricing will be given when 4 or more lessons are pain in advance ($5 off each lesson).

Private lesson (1 student, 15 min. ground, 45 min. saddle time) $75 Semi-Private lesson (2 students, 25 min. ground, 50 min. saddle time) $65 Group lesson (3-4 people, 30 min. ground, 60 min. saddle time) $55

RISE UP Program

InStride’s Riding Academy also offers a unique 8-week program for children called RISE UP. Through small group instruction, students participate in curriculum-based classroom and hands-on instruction that promotes RESILIENCE, INTEGRITY, SELF-AWARENESS, and EMPATHY while being UNAFRAID and PURPOSE-DRIVEN. Each lesson is 90 minutes and includes observations, demonstrations, horse care, and riding while encouraging social interaction and team building.

Cost per lesson- $65 (or $475 when paid in advance)

Ready to ride?

To get started, complete and submit this enrollment packet and one of our instructors will contact you. If you are interested but would like more information, please call or email us and we will be happy to answer your questions. We look forward to helping you discover how horses can enrich your life!

1629 Ranch Road, Nokomis, Florida 34275 941-412-9333 www.InStrideTherapy.org

InStride Riding Academy Enrollment FormDate: ___________________________

Student Name: ____________________________________________________________________________

DOB: ________________________ Age: ____ Height_____ Weight______ Gender: M ____ F ____

Address: __________________________________________________________________________________

Phone: ________________________ Email: _____________________________________________________

Employer/School:___________________________________________________________________________

Address: __________________________________________________________________________________

Phone: ___________________________________________________________________________________

Parent/Guardian: _________________________________________Phone: ___________________________(if student is a minor)

Address: __________________________________________________________________________________(if different from Student’s address)

Emergency Contact: _________________________________________________________________________

Relationship to Student: ______________________________________________________________________

Phone: __________________________________ Alt. Phone: ________________________________________

Describe the student’s prior participation in equestrian activities: ____________________________________________________________________________________________________________________________________________________________________________________

Does the student have specific GOALS related to riding that they hope to accomplish?____________________________________________________________________________________________________________________________________________________________________________________

Which riding discipline is the student most interested in learning? English ____ Western ____ Both ____Please indicate lesson preference (check all that apply): Private ____ Semi-Private ____ Group ____ RISE UP ____ Does the student have their own ASTM approved riding helmet? Yes ____ No ____Is the student a full-time resident? Yes ____ No ____

1629 Ranch Road, Nokomis, Florida 34275 941-412-9333 www.InStrideTherapy.org

Riding Academy Enrollment Continued

HEALTH HISTORY

Please indicate current or past special needs in the following areas:Y N Comments

VisionHearingDizziness/VertigoCommunicationHeart/Blood PressureBreathing/AsthmaMigrainesBehavioralEmotional/Mental HealthBone/JointThinking/CognitionAllergiesCancer/Other DiseaseSeizures/Fainting

MEDICATIONS (include prescription and over-the-counter medications and any side effects experienced)____________________________________________________________________________________________________________________________________________________________________________________

ANY EXISTING CONDITIONS THAT MAY REQUIRE ADDITIONAL ACCOMODATIONS (examples: mobility, balance, pain, asymmetry) _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

By signing below, the student (or parent/guardian) acknowledges that they have read and understand the safety and health policies and procedures that are in effect at InStride Therapy and that the information they provided in this enrollment form is accurate and true.

Signature:____________________________________________ Date: ____________________________Participant/Parent or Legal Guardian

1629 Ranch Road, Nokomis, Florida 34275 941-412-9333 www.InStrideTherapy.org

For official use only:

Reviewed by: ________________________ Date of enrollment: __________________

Date of 1st lesson: _____________________ Instructor: ___________________________

Liability Release, Waiver and Assumption of Risk Agreement

Please note: under Florida law, an equine activity sponsor or equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities. If participant is under the age of 18, signature of parent/guardian is required. Thank you.

____________________________________________________ (Participant’s Name) would like to participate in activities at InStride’s facilities. I acknowledge the risks and potential for risks with horses and horseback riding. However, I feel that the benefits to me/my son/my daughter/my ward are greater than the risk I/they assume. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against InStride, its Board of Directors, Instructors, Therapists, Aides, Volunteers and/or Employees for any and all injuries and/or losses I/my son/my daughter/my ward or I may sustain while on InStride’s property and/or participating in activities at InStride.

SIGNATURE: ___________________________________________________________DATE: _______________ (Participant, Parent/Guardian)

IN CASE OF EMERGENCY, PLEASE NOTIFY:

Name: __________________________________________________Relationship: ________________________________

Home Phone: ________________________Work Phone: ______________________Cell Phone: ____________________

Physician: _________________________________________________Phone: ___________________________________

Preferred Medical Facility: _____________________________________________________________________________In case of emergency, I give my permission to InStride Therapy to secure any medical treatment deemed necessary including: x-ray, surgery, hospitalization, and medication.

SIGNATURE: ___________________________________________________DATE: ___________________ (If participant is under the age of 18, the signature of a parent/guardian is required)______________________________________________________________________________________________________________

PHOTO RELEASE (OPTIONAL)By signing below, I hereby consent to and authorize the use and reproduction by InStride of any and all photographs and any other audiovisual materials taken of me/my son/my daughter/my word for promotional material, educational activities or for any other use for the benefit of the program.

SIGNATURE: _________________________________________________DATE:______________ (Participant, Parent/Guardian)

1629 Ranch Road, Nokomis, Florida 34275 941-412-9333 www.InStrideTherapy.org