Offering Alternative Therapy with Smiles, Incorporated
~ horseback riding for the disabled ~
O.A.T.S. hrh
Volunteer Registration Form
Thank you for your interest in volunteering with O.A.T.S. !
As you probably know, our program provides therapeutic riding for people with disabilities. This program
could not exist, if it were not for our dedicated volunteers. We welcome your participation, and hope you will
find this to be a rewarding experience.
All volunteers will be given an ‘on-site’ orientation. Additionally, you will find some important information
about ‘leading horses’ and ‘side walking with our riders’ included with this mailing. Please read these sheets
before your first volunteer session. (Do not turn them in with your registration.)
Instructions for filling out your Volunteer Registration Form:
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You should be able to complete this form on your computer by typing in each field as you tab across and
down the page. If there is a
you can click on the box and it will enter a ✓.
If you know how to include an ‘electronic signature or initials’, you can add that in the required fields,
along with the date, and then just eMail it back to me at oatsevents@gmail.com.
If you are unable to sign the form, electronically, please eMail it back to oatsevents@gmail.com,
anyway. Then please print & sign, the paper copy. All of the signatures and initials are required. Once
the signatures have been completed, please submit your registration by mail, email or in person.
If, for some reason, you are unable to fill out the application on your computer, you may do so by hand.
However, please use a black pen and print very carefully.
If you have any questions, please do not hesitate to call or eMail me.
Best regards,
Gretchen Hurlbert
oatsevents@gmail.com
248-722-7466
1/14/14
Leading or Working with Horses
Basic Rules for Safety
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Always speak to a horse before approaching or touching him. Most horses are likely to jump and may kick,
when startled.
Never approach a horse directly from the rear. Even in standing stalls, it is possible to approach from an
oblique angle at the rear.
Approach your horse from the side, talking to him in a low voice. Keep your hand on your horse when walking
around him.
If the horse hangs back on the end of the rope, lead him a few steps forward before touching him with your
hand.
Walk beside the horse when leading him – not ahead or behind his head.
Use a long lead shank and both hands when leading. If the horse rears up, release the hand closest to the halter
so you can stay on the ground.
You weigh a lot less than any horse. You cannot out-pull him. If a horse pulls back, step with him rather than
pull against him. A quick jerk on the lead rope will generally get him going.
Never wrap a lead shank or reins around your hand, wrist or body. Fold any excess rope over the palm of your
hand and then close your fist around it
Pet a horse by placing your hand on his shoulder or neck. DON’T dab at the end of his nose.
Always walk around your horse – never under the rope or stepping over it.
After leading into a box stall, turn the horse so that he faces the door. Before releasing the lead rope, close the
stall door leaving, just enough space for you to get out, but not the horse.
Lead your horse from the left side – one hand about 6” from the halter and looping the other end of the lead
road over the palm of your hand, not wrapped around it.
When bridling a horse, keep your head in the clear. He may throw his head or strike to avoid the bridle. Avoid
bridling a nervous animal in close quarters.
When saddling a horse, stand with your feet well back. You should have to lean forward to lift and place the
saddle on his back.
Adjust saddle, carefully, and cinch tightly enough so it will not turn when mounting. Horses often “swell up”
when first saddled. Check the girth, again, before mounting a rider. Failure to tighten can result in serious
accidents.
Always unhook the lead rope before taking the halter off your horse. This may prevent him from pulling back
and becoming a “halter puller”. Never remove the halter before the horse is completely in the stall or pen.
Keep reins and leads ropes off the ground.
When checking or cleaning a horse’s hooves, do it from the side, facing the rear. Never squat or kneel down.
Stay up on both feet.
When leading a horse during classes, remember that when the horse is at a “Whoa”, the leader must come
around in front of the horse and stand ‘nose to nose’ with the horse. Both hands must remain on the lead
rope, all times. Do not take this as an opportunity to ‘pet the horses’ face’ or snuggle up to him/her.
1/14/14
Effective Side-walking
Side-walkers are the ones who normally get the most “hands-on” duties in therapeutic riding. They are directly
responsible for the rider. As such, they have the capability to either enhance or detract from the lesson.
All of our riders are disabled, but it is important to focus on their abilities, rather than their disability. Each rider is
unique, and it is very helpful to know how much your rider is capable of and how best to assist him or her. It is the
instructor’s responsibility to provide each side-walker with that information. Sometimes we get really busy or
assume you already know the rider in your care. Don’t ever hesitate to ask the instructor any questions about
your role. There are “no stupid” questions in therapeutic horse back riding.
Always remember that you must have both hands ‘ready’ to react, at all times. No hands in the pockets and no cell
phone usage during classes,
In the arena, the side-walker should help the student focus his/her attention on the instructor. Try to avoid
unnecessary talking with either the rider or other volunteers. Too much input from too many directions is very
confusing to anyone, and to the riders who already have perceptual problems, it can be overwhelming. If two sidewalkers are working with one student, one should be the “designated talker” to avoid this situation.
When the instructor gives a direction, allow your student plenty of time to process or think about it. If the
instructor says, “Turn to the right toward me,” and the student seems confused, gently tap the right hand and say,
“right”, to reinforce the command. You will get to know the riders and learn when they need help and when they’re
just not paying attention.
It’s important to maintain a position by the rider’s knee. Being too far forward or too far back will make it very
difficult to assist with instructions or provide security if the horse should trip or “shy”.
There are two ways to hold onto a rider, without interfering. The most commonly used is the “arm-over-the-thigh”
hold. The side-walker grips the front of the saddle (flap or pommel, depending on the horse’s size) with the hand
closest to the rider. Then the fleshy part of the forearm rests gently on the rider’s thigh. Be careful that the elbow
doesn’t accidentally dig into the rider’s leg or the horse’s back.
Sometimes, pressure on the thigh can increase and/or cause muscle spasticity with the cerebral palsy population.
In this case, the “therapeutic hold” may be used. Here, the leg is held at the joints, usually the knee and/or the
ankle. Check with the instructor/therapist for the best way to assist. In the (unlikely) event of an emergency, the
arm-over-the-thigh hold is the most secure.
Avoid wrapping an arm around the rider’s waist. It is tempting when walking beside a pony with a young or small
rider, but it can offer too much and/or uneven support. At times, it can even pull the rider off balance and make
riding more difficult. Encourage your students to use their own trunk muscles to the best of their abilities.
1/14/14
Offering Alternative Therapy with Smiles, Incorporated
~ horseback riding for the disabled ~
O.A.T.S. hrh
Volunteer Registration Form
You should be able to fill this out on your computer.
If you are filling this out by hand, please print clearly & use black or blue ink.
How did you learn about OATS?
Date:
Name:
DOB:
Age:
Mailing Address:
Gender:
Male
Home Phone:
Female
Email Address:
Cell Phone:
Parent/Guardian (if under 18):
Address, if different from above:
Phones – Home:
Cell:
Work:
My Participation as a Volunteer
Please mark the boxes below next to the areas for which you would like to volunteer.
Horse Handling
Volunteer Recruitment
Public Relations
Fund Raising
Side Walking with a rider
Leading Volunteer Groups
Speakers Bureau
Grant Writing
Stable Management
Photography/Video
Special Events
Website help
Facility Repairs
Electrical
Plumbing
Carpentry
Landscaping & Grounds
Help with Mailings/office
You tell us how you would like to assist our organization:
I am here to volunteer for this One Time special event, only: (please specifiy):
I am available to help with classes during the times I’ve checked below:
Mon 5-8 pm
Tues a.m.
Tues 5-8 pm
Wed 5- 8 pm
Thurs 5-8 pm
Sat 8-12noon
other
Do You Need Community Service Hours?
For what organization do you need hours?
No
Yes How many hours?
If yes, you need to fill out and bring the included community service log with you, each time you volunteer. It is your responsibility to
make sure it is signed when you arrive and again when you leave. OATS cannot document your hours, unless this log is completed.
Thanks for your co-operation!
1/14/14
Health & Activity Information
Do you have any allergies?
Are you allergic to any medications?
Physical limitations or Medical Conditions?
Last tetanus shot date:
Latest TB test:
Result:
Negative
Positive
Can you walk for 60 minutes & jog short distances?
Can you support a rider by holding him by the waist or belt? (This may mean keeping your arm above shoulder height.)
yes
no
Are you comfortable working with horses & other animals?
Yes
No Please list any experience you’ve had with animals:
Do you have any experience working with people with disabilities?
Yes
No If yes, please explain:
Personal Background & Information Release
Have you ever been charged with or convicted of a crime? Yes
No
If yes, please explain:
I,
, authorize OATS to receive information from any law enforcement agency, including police
departments and sheriff’s departments, of this state or any other state or federal government, to the extent permitted by state and
federal law, pertaining to any convictions I may have had for violations of state or federal criminal laws, including, but not limited to,
convictions for crimes committed against children or animals. I understand that such access is for the purpose of considering my
applications as an employee/volunteer and the I expressly DO NOT authorize O.A.T.S., its directors, officers, employees, or other
volunteers to disseminate this information in any way to any other individual, group, agency, organization, or corporation.
Signature: (Parent or Guardian, if under 18:
Printed Name:
Do you have a current Drivers License: YES
Date:
NO
License # & State:
Confidentiality Agreement
I understand that all information (written and verbal) about O.A.T.S. participants is confidential and will not be shared with anyone
without the expressed written consent of the participant and their parent/guardian (in the case of a minor).
Signature: (Parent or Guardian, if under 18):
Date:
Printed Name:
Liability Release
I,
, would like to participate in the O.A.T.S.hrh riding program. I acknowledge the risks and dangers,
together with potentials risks and dangers of horseback riding. However, I think that the possible benefits to myself/my son/my
daughter/my ward are greater than the risks assumed. I have read the warning mandated by the Michigan Equine Activity Liability
Act. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors, administrators or personal representatives,
waive and release forever all claims for damages against O.A.T.S. hrh, its Board of Directors, Instructors, Therapists, Aides,
Volunteers and/or Employees for any and all injuries and/or losses that I/my son/my daughter/my ward may sustain while
participating in O.A.T.S.hrh activities or upon the O.A.T.S.hrh premises.
Signature: (Parent or Guardian, if under 18):
Printed Name:
Date:
1/14/14
Photo Release
I hereby consent to and authorize the use and reproduction by O.A.T.S.hrh of any and all photographs and any other audio/visual
materials taken of me/my son/my daughter/my ward for promotional printed material, educational activities or any other use for the
benefit of O.A.T.S.hrh programs.
Yes
No
Signature: (Parent or Guardian, if under 18):
Printed Name:
Date:
Michigan Equine Activity Liability Act Warning
I understand that under the Michigan Equine Activity Liability Act, an equine professional is not liable for an injury to or the death of a
participant in an equine activity resulting from an inherent risk of equine activity.
Signature: (Parent or Guardian, if under 18):
Printed Name:
Date:
Authorization for Emergency Medical Treatment
You must sign either “Consent Plan” or “Non-Consent Plan”
In the event that emergency medical aid and/or treatment is required due to illness or injury, during the process of receiving services,
while volunteering or while being on the premises of O.A.T.S.hrh, I authorize O.A.T.S.hrh :
 To secure and retain medical treatment and transportation, if needed.
 To release client records, upon request, to the authorized individual or agency involved in the emergency medical treatment.
Emergency Contact:
Phone:
Secondary Emergency Contact:
Phone:
Physician’s Name:
Phone:
Preferred Medical Facility:
Health Insurance:
Policy Number:
CONSENT – I DO give my consent for emergency medical treatment. This authorization includes x-ray, surgery, hospitalization,
medication and any treatment or procedure deemed “life saving” by the physician. This provision will only be invoked if the person
listed below is unable to be reached.
Name:
Phone:
Address:
City, State, Zip
Signature: (Parent or Guardian, if under 18):
Printed Name:
Date:
NON-CONSENT - I DO NOT give my consent for emergency medical aid and/or treatment in case of illness or injury during the
process of receiving services, while volunteering or while being on the premises of O.A.T.S.hrh. In the event that emergency treatment
or aid is required, I wish the following to take place: (please fill in your express directions:)
Signature: (Parent or Guardian, if under 18):
Printed Name:
Date:
Class Cancellation Notification
In the rare event that a class or event must be cancelled, for which you are scheduled to volunteer, we will text or eMail you.
Cell phone # & provider (i.e., 1234567890@Verizon):
eMail address:
1/14/14