• Participant Registration

    New Hope Equine Assisted Therapy
  • NOTE:  This is a multi-page registration. It is recommended to access via a computer or tablet. 

    Upon submission, you will receive a copy of the information you submitted via the email you provide on this form. Then the information will be reviewed by our Programming Coordinator who will follow up with you shortly. If you have any questions, contact our Programming Coordinator at Program@NewHopeEquine.com

    For details on how your privacy is protected, please review our New Hope Privacy and Security statement posted on our website.

    And thank you for considering New Hope Equine Assisted Therapy!

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  • Participant Information

  • Please note that our program has been established to provide services for those with physical, emotional and/or intellectual disabilities. Riding lessons are only available to those without disabilities during our summer camps. If the participant does not meet this criteria, please contact the Program Manager at New Hope, Program@NewHopeEquine.com before proceeding.

     

  • If you (if registering yourself) or the participant you are registering, has not been diagnosed as having a physical, emotional and/or intellectual disability please contact the Program Manager at New Hope, Program@NewHopeEquine.com to discuss your situation before proceeding. 

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  • Parent/Guardian Information

  • Contact Information

  • Health History

    Equestrian/Participant

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  • EMERGENCY MEDICAL TREATMENT 

    Equestrian/Participant

  • In case of emergency:

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  • Please review the two options below and make your selection below.

    CONSENT PLAN - In the event emergency medical aid/treatment is required due to illness or injury during the process of receiving services or while being on the property of New Hope, I authorize New Hope Equine Assisted Therapy to:

    1. Secure and retain medical treatment and transportation.
    2. Release participants records upon request to the authorized individuals or agency involved in the medical emergency treatment.

    NON-CONSENT PLAN - I do not give my consent for emergency medical treatment/aid in the case of illness or injury during the process of receiving services or while being on the property of New Hope Equine Assisted Therapy. I understand I will be required to complete a separate NON-CONSENT form.

  • You have selected non-consent for emergency medical treatment/aid in the event of illness or injury while on the property New Hope Equine Assisted Therapy, you must contact New Hope to request a Non-Consent Form.

    Please complete the rest of this registration, then send an email to Program@NewHopeEquine.com to request the form.

  • To confirm your consent, please type your first and last name below, select the date and check the Electronic Signature box to acknowledge you have read and understand Emergency Medical Treatment Options and have made your selection.

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  • Photo/Media Release

    1) New Hope Equine Assisted Therapy may use my, my minor child’s, or my ward’s photograph or image in its print, online and video publications; 

    2) I release of New Hope Equine Assisted Therapy, its employees and any outside third parties from all liabilities or claims that I might assert in connection with the above-described activities and 

    3) I waive any right to inspect, approve or receive compensation for any materials or communications, including photographs, videotapes, DVDs, website images or written materials, incorporating photos/images of me, my minor child, my ward.

    Make your selection from the options below then please type your first and last name, confirm the date and check the Electronic Signature box to acknowledge you have read and understand the options for the Photo/Media release.

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  • Legal Agreements

  • Liability Release

    All equine activities at or with New Hope Equine Assisted Therapy involve inherent risks and dangers, which could result in personal injury or death. I/we acknowledge the risks and dangers of a horse-back riding program to myself, my minor child, my ward, or any person(s) I bring onsite to a New Hope Equine Assisted Therapy location or event, however believe that the possible benefits to myself, my child, my ward, are greater than the risks and dangers assumed. 


    UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITES RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES. 


    WAIVER AND RELEASE OF LIABILITY

    I HEREBY, INTENDING TO BE LEGALLY BOUND FOR MYSELF, MY HEIRS AND ASSIGNS, EXECUTORS OR ADMINISTRATORS,  EXPRESSLY WAIVE AND RELEASE FOREVER ALL CLAIMS FOR DAMAGES, COMPENSATION, OR LIABILITY ARISING AGAINST NEW HOPE EQUINE ASSISTED THERAPY, IT’S BOARD OF TRUSTEES, INSTRUCTORS, THERAPISTS, AIDS, VOLUNTEERS, AND/OR EMPLOYEES FOR ANY OR ALL  PERSONAL INJURY OR DEATH THAT I, MY MINOR CHILD, OR MY WARD MAY SUSTAIN IN CONNECTION WITH THE NEW HOPE EQUINE ASSISTED THERAPY ACTIVITY, REGARDLESS OF WHETHER SUCH PERSONAL INJURY OR DEATH IS CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR FAULT OF NEW HOPE EQUINE ASSISTED THERAPY, ITS BOARD OF DIRECTORS, GUARANTORS, INSTRUCTORS, THERAPISTS, AIDES, EMPLOYEES AND VOLUNTEERS ("RELEASEES").


    INDEMNITY AGREEMENT 


    I HEREBY EXPRESSLY AGREE TO INDEMNIFY AND HOLD HARMLESS NEW HOPE EQUINE ASSISTED THERAPY, ITS BOARD OF DIRECTORS, GUARANTORS, INSTRUCTORS, THERAPISTS, AIDES, EMPLOYEES OR VOLUNTEERS ("INDEMNITEES") FROM ANY CLAIM FOR PERSONAL INJURY OR DEATH THAT I, MY MINOR CHILD, OR MY WARD MAY SUSTAIN IN CONNECTION WITH NEW HOPE EQUINE ASSISTED THERAPY ACTIVITIES, REGARDLESS OF WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR FAULT OF INDEMNITEES. 


    I understand that New Hope Equine Assisted Therapy, its Board of Directors, Guarantors, Instructors, Volunteers and/or Staff members (Indemnitees/Releasees) will not be legally liable for any personal injuries or death that I, my minor child, or my ward may sustain in connection with the Equine Activities regardless of any fault or negligence on the part of lndemnitees or Releasees.


    The undersigned acknowledges that he/she has read this Registration & Release form in its entirety; that he/she understands the terms of this release and has signed this release voluntarily and with full knowledge of the effects thereof. 

    Please type your first and last name below, confirm the date and check the Electronic Signature box to acknowledge you have read and understand the liability release.

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  • Confidentiality Policy Agreement

    At New Hope, we place great importance on protecting the confidential information of our clients, our staff and our volunteers. “Confidential Information” includes, but is not limited to, personally identifiable information such as surnames, telephone numbers, addresses, e-mails, etc., as well as the non-public business records of New Hope. In particular, medical information about clients, and information about their disabilities or special needs, must be protected as Confidential Information. Volunteers shall never disclose Confidential Information to anyone other than New Hope staff. Volunteers must seek staff permission before taking any pictures or videos.

    Please type your first and last name below, confirm the date and check the Electronic Signature box to acknowledge you have read and understand the New Hope Confidentiality Policy and agree to abide by same.

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  • PARTICIPANT CONTRACT

  • The following are requirements that must be read and adhered to while participating in the lessons offered at New Hope.

    PAYMENT FOR LESSONS:

    1. Tuition is $60 per lesson, one per week minimum, payable to New Hope by cash, check, or PayPal.  Payments may be made weekly or monthly online or by placing your payment in an envelope in the locked mail box to the right of the office door.

    2. Payment may also be made when your invoice is emailed to you. There is a link in the invoice which allows you to make payment immediately with your credit/debit card.

    3. If the equestrian’s tuition is being funded by a third-party payer, New Hope will invoice the third-party payer.  However, the equestrian or parents/guardians of the equestrian are ultimately responsible for payment.

    * Please note that all outstanding accounts need to be paid in full prior to starting each September.

    ATTENDANCE:

    If an equestrian is unable to attend their scheduled lesson, a 24 hour advance notice is appreciated.  If an Equestrian does not give adequate notice or is a “no show,” he or she will be charged the entire cost for that lesson.  If the equestrian’s tuition is being funded by a third-party payer, the third party payer will not pay for classes and the equestrian will maintain the responsibility of payment.

    a. Equestrians with 3 (three) unexcused absences may be removed from the program with the loss of payment received for classes.

    b. Emergency situations are the only exception for not calling to cancel.

    In the event an equestrian no longer wants to participate in the program, a one-week notice would be greatly appreciated.  This allows New Hope to schedule staff, volunteers and horses accordingly. 

    Please type your first and last name below, confirm the date and check the Electronic Signature box to acknowledge you have read and understand the payment and attendance policy.

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  • SUBMISSION PAGE

    Thank you for your interest in New Hope Equine Assisted Therapy. Once you hit the submit button, your application will be sent to our Programming Coordinator. You will be contacted directly by a member of our staff regarding next steps. 

    You will also be directed to the New Hope Physician Medical Form which must be completed annually or upon any change in health and/or diagnosis. The medical form must be received at New Hope before your registration can be completed and the initial assessment scheduled.

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