Background Check

Winslow Therapeutic Riding Center
1433 State Route 17A Warwick, NY 10990
Phone: (845) 986-6686

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* Today's Date

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* Contact Information

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* If under 18 years of age, please provide contact information for Parent/Legal Guardian

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* Reference Check (please provide one reference who is not a family member or friend)

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* Have you ever been convicted of a crime?

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* Purpose for Volunteering

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* By entering your full name as your legal signature in the box below, you are attesting that everything in this document is true to the best of your knowledge.

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