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* 1. Name (Optional)

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* 2. Center Affiliation (Optional)

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* 3. Email Address (Optional)

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* 4. PATH Intl. Affiliation (please mark all that apply

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* 5. Complete the following table

  Therapeutic Riding or Adapted Riding Hippotherapy Equine-Assisted Learning Equine-Assisted Psychotherapy Veterans or Active Duty Program Able-Bodied Rider Community Camp (ex. Summer Camp) Equine Exerciser or Schooler Volunteer Lessons Single Event or Workshop or School Group
Which of these services do you offer at your center?
Which of the following do you consider to be a participant at your center?
Which of the following receives a benefit from center activities?
Which are covered under the center's main insurance policy?
Which of the following requires an insurance rider or separate policy?
Which of the following ride/drive/vault/participate under the umbrella of the PATH Intl. program?
Which of the following do you keep activity/progress notes on?
Which of the following do you require a new participant intake for?

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