join the herd

Participant application

This application helps us learn about your child and family so we can find the best fit. All information is kept confidential and used solely for enrollment, scholarship consideration, program matching, and safety planning. It takes about 7–10 minutes.

Your pathway

Which participation pathway are you interested in?

Scholarship Participant (For families seeking full or partial financial assistance.)Community Participant (For families participating through standard lesson, program, or activity fees.)Service & Leadership Participant (For youth seeking volunteer opportunities, leadership development, mentorship experiences, fundraising involvement, or service hours.)Unsure — I would like a member of the Saddle Up for Hope team to help determine the best fit for my family.

Parent/Caregiver & child

Parent/Caregiver Full Name

Relationship to Child

Phone Number

Mailing Address (Street, City, State, Zip)

Child's Full Name

Child's Date of Birth

Child's Gender

MaleFemale

School & Grade Level

Support history & needs

These answers help us plan a safe, supportive experience — they are never used to exclude a child.

Has your child ever attended therapy or counseling?

YesNo

Was it beneficial?(optional)

How would your child like to participate? (Check all that apply)

Any behavioral, emotional, sensory, social, or medical concerns we should be aware of to better support your child?(optional)

Any triggers, fears, sensitivities, or situations that may cause your child distress?(optional)

Your goals

What are you hoping your child/family will gain from participating in Saddle Up for Hope?

I understand that submitting this form does not guarantee acceptance into the program and that additional interviews and paperwork may be required.

YesNo

Acknowledgments, waivers & agreements

Please read each statement carefully and acknowledge your agreement by checking each box.

ASSUMPTION OF RISK & LIABILITY WAIVER

I understand and acknowledge that participation in horseback riding, horse handling, barn activities, farm activities, volunteer projects, events, transportation, and other equine-related activities involves inherent risks. Horses are unpredictable animals and may react unexpectedly to sounds, movements, weather conditions, people, animals, or other environmental factors.I voluntarily assume all risks associated with participation, including but not limited to falls, kicks, bites, collisions, property damage, illness, emotional distress, permanent injury, disability, or death. I agree to release, hold harmless, and indemnify Saddle Up for Hope, its officers, directors, volunteers, mentors, instructors, coaches, staff, sponsors, community partners, property owners, and affiliates from liability arising from participation except where prohibited by law.

EMERGENCY MEDICAL AUTHORIZATION

In the event of an emergency, I authorize Saddle Up for Hope staff, volunteers, instructors, and representatives to seek emergency medical treatment for my child if I cannot be reached immediately. I understand I am responsible for any resulting medical expenses.

MEDIA RELEASE

I grant Saddle Up for Hope permission to photograph, record, and use images, videos, audio recordings, testimonials, success stories, artwork, and program participation information involving my child and/or family for educational, promotional, fundraising, grant applications, annual reports, social media, newsletters, websites, presentations, and community awareness efforts without compensation.

PROGRAM PARTICIPATION ACKNOWLEDGMENT

I understand Saddle Up for Hope does not provide medical treatment, mental health treatment, counseling, psychotherapy, diagnosis, or healthcare services unless specifically provided by a separately licensed professional acting independently of Saddle Up for Hope.I understand participation does not guarantee any specific outcome, improvement, or result.

SCHOLARSHIP AGREEMENT

I understand that scholarship funds are limited and are made possible through grants, donations, sponsorships, and community support.I understand that submitting a scholarship application does not guarantee scholarship approval, enrollment, or placement.I certify that all financial and household information provided is truthful and accurate to the best of my knowledge.I understand that knowingly providing false or misleading information may result in denial, revocation of scholarship assistance, or dismissal from programs.

CODE OF CONDUCT AGREEMENT

I agree to help maintain a safe, respectful, and supportive environment for all participants, families, volunteers, horses, staff, and community partners, and I understand the behaviors listed below may result in suspension or removal from programs.

Behaviors that may result in suspension or removal from programs: bullying or harassment · threatening behavior · physical aggression · discrimination · inappropriate sexual behavior · possession of weapons · illegal drug or alcohol use during program activities · repeated disruption of programs · unsafe behavior around horses, people, or property · intentional damage to equipment, facilities, or animals.

ANIMAL WELFARE AGREEMENT

I understand that the safety and welfare of horses is a priority of Saddle Up for Hope, and I agree to the expectations described below.

Participants and families agree to follow all barn rules, instructor directions, safety requirements, and horse care expectations. Unsafe treatment of animals may result in immediate dismissal from programming.

VOLUNTEER & SERVICE EXPECTATIONS

If participating in volunteer, leadership, mentoring, fundraising, or service programs, I understand that Saddle Up for Hope expects participants to represent the organization respectfully both in person and online.

Service hours may be withheld if expectations are not met.

CONFIDENTIALITY & COMMUNITY RESPECT

I understand that participants may share personal experiences, challenges, and stories during programs, and I agree to respect the privacy and confidentiality of other participants and families and will not share private information without permission.

PROGRAM REMOVAL POLICY

I understand that Saddle Up for Hope reserves the right to deny, suspend, or terminate participation when it determines that continued involvement may negatively impact participant safety, horse welfare, staff, volunteers, community partners, or the mission of the organization.

INTELLECTUAL PROPERTY & PROGRAM MATERIALS

I understand that Saddle Up for Hope curriculum, program materials, training resources, handbooks, worksheets, branding, logos, educational materials, and proprietary program concepts remain the property of Saddle Up for Hope, and that materials provided through participation may not be copied, reproduced, sold, distributed, or used to create competing programs without written permission.

CERTIFICATION — I certify that the information provided in this application is true and accurate to the best of my knowledge, and I have read, understand, and agree to the policies, waivers, acknowledgments, and expectations outlined above.

YES

I certify that all financial and household information provided in this application is truthful and accurate to the best of my knowledge.

YES

Signature

By typing your name below, you acknowledge that your electronic signature has the same force and effect as a handwritten signature.

Parent/Guardian Name (typed signature)

Participant Name(s)

Today's date

Questions? Contact Tammy Chester-Jenkins, Founder & Executive Director — hello@saddleupforhope.org · 706-300-0538