MHTA Student Enrollment Application

A $600.00 deposit is required and should be submitted along with your Enrollment Application via US Mail or by online payment.

Click here for a printable form

Name

First Name

Last Name

Age

Phone Number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

(###)

###

####

Horse Information

The State of Wisconsin requires a State Certified proof of Negative Coggins and a State Certified health certificate for your horse within the past 30 days before permitting entry into Wisconsin. Please bring both certificates with you if you plan to attend with a horse.

Name of Horse

First Name

Last Name

Breed of Horse

Age of Horse

Questionnaire

Do you have any disabilities that we would need to assist you with. If so, what type of assistance could we help you with?

Where did you hear about this class?

Do you need us to provide a horse for you?

What do you know about the background of the horse you are bringing - such as bad habits, problem areas, attitude, physical limitations or abilities and accomplishments?

What is your experience with horses?

Have you ever attended or been involved with any other horse related program, If so, where?

When you learn the amazing results we guarantee in this program, would you like us to advertise your training and education with us at no cost to you in your local newspaper? If so, please provide us with the Name, City & State of your local newspaper:

MHTA Student Enrollment Application

Devil’s Hole Ranch

Mailing Address

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Clinic Site