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  • Participant Information

    Please be as thorough with your answers as possible. The more we understand about you, the better we can serve you! As a nonprofit organization, we rely heavily on grants that require us to report demographic information about our participants. Thank you for providing this information so that we can continue to provide our high-quality programs at the lowest cost possible. All information is protected by our confidentiality policy.
  • Healing Reins' Services

  • Note: If you are not sure which service you would like to enroll in, please contact Candace Martin, Operations Coordinator at: (541) 382-9410 or candacem@healingreins.org

     

    • Adaptive Horsemanship: includes groundwork and riding for participants of all ages, abilities, and experience levels
    • REACH: After school and summer workshops for students ages 9-18. Includes groundwork and classroom experiences
    • Heroes Horsemanship: Groundwork and riding tailored for Veterans and First Responders, and their families
  • Again, if you are not sure which service you would like to enroll in, please contact Candace Martin, Operations Coordinator at: (541) 382-9410 or candacem@healingreins.org

     

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  • **Note: Healing Reins defines "First Responder" as: law enforcement officers, paramedics, EMT's, firefighters, and nurses, doctors and other medical personnel who are also required to respond directly to disasters and critical situations.


  • First Aid & Emergency Contact Information

  • Please note: Healing Reins automatically calls 911 in cases of seizures lasting over 2 min. or multiple seizures in a short time frame

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  • Health & Cognitive Information

  • Release of Information Consent

    Healing Reins will fax the required Physician's Release form to the participant's primary care provider and any other service providers authorized below.
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  • Photo & Publicity Release

    Do you consent to and authorize the use and reproduction by Healing Reins of any and all photographs and any other audio/visual materials for promotional material, educational activities, exhibitions or for any other use for the benefit of the program.
  • Heroes' Family Members

    If you would like to participate in Heroes' Family events, please share your family members' names, ages, and relationship to you.
  • Agreement, Consent & Release

    • The information provided is, to my knowledge, accurate and current.
    • CONSENT FOR EMERGENCY MEDICAL TREATMENT: In the event of an emergency, if medical aid/treatment is required due to illness or injury while participating in the services of, or while being on the property of, Healing Reins Therapeutic Riding Center (“Healing Reins”), an Oregon non-profit corporation, I authorize Healing Reins to secure and retain medical treatment and/or transportation if needed. This authorization includes any treatment deemed necessary by a treating health care professional and includes, but is not limited to, x-ray, surgery, hospitalization, and medication. In addition, I authorize Healing Reins to release my/my child/my ward’s records to any individual involved in medical treatment and/or necessary transportation.
    • LIABILITY RELEASE: Under Oregon Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of participating in equine activities, pursuant to section 30.691, Oregon Revised Statutes. I would like to participate in HRTRC’s program. I acknowledge the risks and potential for risks in riding and working with horses. However, I feel that the possible benefits to myself/my child/my ward are greater than the risks assumed. Intending to be legally bound, for myself and my heirs, assigns and legal representatives, I hereby forever waive and release any and all claims, whenever arising, against Faith Run Farms, LLC (“FRF”) an Oregon limited liability company, Healing Reins, and their respective directors, officers, members, employees, agents and representatives arising from, or relating in any way to my/my child’s/my ward’s participation in any Healing Reins program or presence on the FRF property generally.
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