09/07/2026
APPLICATION TO PARTICIPATE IN CONNECTIONS, A 12 WEEK PROGRAM ON RELATIONSHIP.
NAME_______________________________________________DATE__________
DATE OF BIRTH¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬-______________________________________________________
PARENTS’/GUARDIANS________________________________________________CONTACT INFO, ADDRESS/PHONE
TELL US WHY THIS PROGRAM APPEALS TO YOU AND WHAT YOU WOULD LIKE TO LEARN FROM IT: ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬-___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________lPlease return to Riley Equine Center, 17244 Doyle Rd., Boonville,MO 65233. [email protected]