Student Application 2024
Student First / Last name
Please provide the first and last name of the student
Age of Child
Must be at least 7 years of age.
Please select
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Please select
Child Date of birth
Please provide the birthday in a Month/DAY/YEAR format
What is your child's grade level
Please provide their current grade level.
Please select
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Please select
Parent/Guardian Name
Provide the first and last name of the parent or guardian
Mailing address for your child
Parent/Guardian Phone number
Parent/Guardian Email address
Best time to call
Please let us know when the best time to contact you
Please select
AM
PM
No preference
Please select
Can we leave a message at this number?
Yes
No
Any restricted visitors
Please let us know if there are individuals who are not allowed to have contact with your child.
How did you hear about Hooves of Hope
Please select
Facebook
Event
Family &/or Friend
Other
Please select
Are you a returning student?
Returning Student
New Student
Please choose the session you would like your child to attend. All sessions are every Thursday for 4 weeks from 6:30pm-8:15pm.
Please select the date that best fits your schedule.
Please select
Sessions are full for the 2024 season
Please select
Any medical conditions (asthma, diabetes, seizures, migraines, etc). Please list:
Does your child have any allergies (seasonal, food, medication):
Are there triggers to your child's physical or emotional behavior that we should be aware of?
Childs favorites: ex. food, color, animal etc.
Childs interest/hobbies:
May we discuss this information with your child's Wrangler?
Yes
No
Emergency Contact
Emergency Contact phone number
Do you authorize this person to pick up your child if needed?
Signature
Clear
Date
MM
/
DD
/
YYYY
Verification
SUBMIT FORM
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