Skip to Content

Contact Us

Are you or is someone you know interested in our organization or services? Feel free to contact us anytime.

Contact Us

Name *

First Name

Last Name

Email *

Phone

(###)

###

####

Message *

Thank you!

Do you or someone you know wish to participate in the Hold the Reins program? Fill out the form below:

Contact Form

General Information

Name *

First Name

Last Name

DOB

MM

DD

YYYY

Age

Participant Email *

Participant Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Subject *

Emergency Contact *

First Name

Last Name

Emergency Phone

(###)

###

####

Relationship

Spouse

Parent

Sibling

Other

Message *

Participant Medical Information

Overall Health

Excellent

Good

Fair

Poor

Medical Conditions

Check any that apply

Allergies

Asthma

Seizers/epilepsy

Balance issues

Pregnant

Diabetes

Brain injury

Heart conditions

Other

-If other, please briefly explain:

Additional Information

Please describe what prompted you to enroll in the Hold The Reins program.

What would you like to learn at Hold The Reins?

What do you think is important for us to know about you?

What is your experience with horses?

Thank you for your submission. An HTR team member may reach out to further process your request.

Hold the Reins est. 2023

contact-us@holdthereins.org