Client Interest Form

Personal Information

First name

Last name

Email

Phone

Preferred Contact Method

Phone

Email

Text Message

Address

Participant Details

Age(s) of Participant(s)

Are you a veteran or active duty service member?

Yes (Veteran)

Yes (Active Duty/Reserve/Guard)

No

Prefer not to say

Program Selection

Program(s) of Interest

Motivation & Needs

What inspired you to reach out today?

Availability

Preferred time of day:

Mornings

Afternoons

Evenings

Flexible

Safety & Considerations

Do you or the participant have any allergies, physical limitations, or concerns we should be aware of?

Have you or the participant worked with horses before?

Yes

No

A little/not much

Additional Info

Anything else you would like us to know?

Consent & Acknowledgment

“I agree to be contacted by BraggTower Ranch regarding programs and updates.”

“Yes, subscribe me to the newsletter.”

“I understand this form is an inquiry only and does not guarantee enrollment. All programs follow BraggTower Ranch’s safety guidelines and availability.”