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TROT - New Rider Application

To ensure coordinated care,Therapeutic Riding of Tri-Cities (TROT) staff and volunteers are provided with information about participant’s abilities/disabilities.

Date
Month
Day
Year
Gender
Male
Female

Physical Skills

Is the participant proficient in the following physical skills?

Sits unassisted
Yes
No
Releases Objects
Yes
No
Stands Independently
Yes
No
Runs Unassisted
Yes
No
Walks Unassisted
Yes
No
Climbs Stairs
Yes
No
Uses Hands Independently
Yes
No
Uses Bathroom Independently
Yes
No
Does the participant use any of the following:
Hand Preference
Right
Left
No Preference

Sensory Skills

Please describe any sensitivity in the following areas:

Any sensitivity to any of these

Cognition and Processing Skills

Please describe any sensitivity in the following areas:

Does the rider have difficulty following multi-step instructions?
yes
No

Communication Skills

Does the rider use verbal speech to communicate?
yes
No
Does the rider have difficulty understanding spoken language or expressing themselves?
Yes
No
Other

Behavioral and Social Considerations

Does the rider have any challenges with social interactions or group settings?
Yes
No

Safety Awareness & Decision-Making

Does the rider recognize and respond to potential dangers? (e.g. understanding when to stop, listening to safety instructions)
Yes
No
Does the rider require assistance making safe choices in physical activities?
Yes
No

Personality Profile

Learning style

(choose one)
Visual/learns by seeing
Auditory/learns by hearing
Kinesthetic/learns by doing
We (I) will be completing the Financial Aid Form (circle one):
YES
NO

Upon TROT receiving your submission, our family coordinator will contact you to set up your free 30 minute riding assessment.

Get in Touch

​
104 E. 41st Place Kennewick, WA 99337

 

(509) 412-0112

 

info@trot3cities.org
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Legal
​

IRS-501C

 

TROT Policies and Procedures

 

Current 990 available for review upon request.

 

Trot Therapeutic Riding of Tri-Cities was formed as a Washington Corporation on May 12, 2014.

 

Trot has been determined by the IRS to be a 501 (c) (3) tax-exempt organization. Donation receipts are available for tax deductions.

 

Governing documents, Conflict of interest , 990’s and financial statements available upon request.

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Site Designed and Maintained by: TROT Staff

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