Horse Connections Prevention Programs Inquiry Form

MRT offers individual and group horse connections programming.

Please email office@moonrisetherapeutics.org or call 802-299-8192 if you have any questions/concerns.

Please note: Experience with horses is not required to participate in horse connections prevention programming. Financial options are available, we work to support equal access.

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Name *

First

Last

Date of Birth

If Not Yourself- Name and DOB of the person you are submitting for:

Relationship to the person you are submitting for:

Town Yourself- of

Mailing Address

Email *

What Town Do You Live In? *

How did you hear about MoonRise Therapeutics?

Have you participated in programs at MRT before?

What is your experience with horses?

Which programs are you interested in? *

• Individual Horse Connection Lessons
• Adult Horse Connections
• WAITLIST-Summer MoonRise Farm Adventure Camp
• Partnering With Horses for Healing

What are your hopes in working with us? *

Is there anything else you would like us to know?

Submit Inquiry

By submitting your information, you’re giving MRT permission to email you.

Thank you for registering! We will be in touch soon to confirm your registration and to email you permission forms and directions if needed.