Client Information Form
Please complete and mail information sheet(s) and a $200 non-refundable deposit to:
Bonnie Treece
Gateway, CO 81522
970-931-2278 batreece@horsesway.com
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Workshop you wish to attend: __________________________ Dates ________________
Name: __________________________________________________________________
Address: ________________________________________________________________
City: __________________________ State: ________________ Zip: ______________
Home Phone: _________________________ Work Phone: ________________________
Email: __________________
Occupation: _____________________________________________________________
Emergency contact name _________________________ Phone: ___________________
Next of Kin (if different) ____________________________ Phone: ___________________
Are you currently working with a counselor or spiritual advisor? Yes No
If not, do you readily have access to a counselor or spiritual advisor? Yes No
Please describe any special needs or issues, such as diet, disabilities, fear of horses, etc. that the staff should know about to better serve you:
Briefly describe your experience with horses (equine experience not necessary):
How did you find out about this workshop/study program?
Describe areas of interest: What would you like to learn from this workshop/study program?
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