Application Form
All payments are made payable to: Sidonia McIntyre
e-mail address for e-transfer is: info@equinerehab.ca
If you are using Visa/MC, please click on the Visa/MC icon and follow the directions
PayPal is the service provider.
If you are mailing your application form, the address is:
Sidonia McIntyre
2776 South Talbot Rd Cottam, ON N0R 1B0
Please indicate the course location and date you will be attending below:
Equine Massage course – location and date: ___________________________________________________________________
Advanced 6 Week Massage Program location and date: ____________________________________________________________
Vertebral Realignment course _______________Date and location of massage course taken ______________________________
Returning grads only: Definition of a “returning graduate”: a person has has already taken the course that they would like to retake, or a grad who would like to now take the 6 week advanced course. If a returning graduate from 2020 to present day would like to retake a course – discount only applies to the course that was previously taken – or wishes to take the advanced course, please check below:
Retake massage course __________ Retake VR ___________
Original course location and year ____________________________________________________________________
_______________________________________________________________________________________________________________
Payment:
Payment in full is required for both the 6 day course – $995 + GST/HST and the vertebral realignment course – $900 + GST/HST
The 6 week course is $3999 + GST/HST and requires a non-refundable deposit of $500. Remaining balance is due 2 weeks prior to the course start date.
I have made an e-transfer payment ________ The correct e-mail for payment is: info@equinerehab.ca
I have made a PayPal payment _______ I have made a Visa/MC payment __________
6 day course – I have enclosed a cheque ________ Name of Bank _________________________________ cheque number _______________
6 Week Advanced Program: if payment is via cheque, I am sending 2 cheques. One with the current date and a second post dated cheque for 2 weeks prior to the course start date:
Name of bank: ____________________________________ Deposit cheque #: ________, remaining balance cheque #: __________
______________________________________________________________________________________________________________________
Please print very clearly and neatly.
Name as it is to appear on your certificate(s): __________________________________________________________________________________
As of the start date of the course, I will be: 18 or over ________ under 18 ________
If you are under 18, your parent/guardian must sign 3 forms: this application form, the 2 page waiver and the 1 page ‘under 18’ waiver
If you are over 18, you need only sign the 2 page waiver and this application form
Address: _________________________________________________________________________________________________________________
City:_____________________________________________________ Province: ___________ Postal Code: _________________
Cell Phone: (_______)________________________________________ Home Phone: (______)_____________________________________
Email: __________________________________________________
Horse experience (check one please) regarding ground work with horses:
I am: very ____ fairly ____ somewhat _____ not at all _____ confident.
I have: lots _____ some______ no _____ experience
How did you learn out about this course?
magazine (name) _____________________________________ website/google/surfing internet ___________
equine federation website ________ other website link ____________________________
other _____________________________________
By signing below, I (or the parent/guardian on behalf of the minor) agree that:
I have read the “Cancellation and Refund policy” located on: www.equinerehab.ca and agree to the terms and conditions therein. ____________** (Initial please)
If I need to cancel my attendance in the course, I will send an e-mail; however the cancellation is not binding unless I receive a reply from Sidonia. I understand and accept that the reply e-mail from Sidonia is the only acceptable form of proof that I have cancelled my attendance from the course. _____________ ** (initial please)
I understand that it is to be presumed that all courses are moving forward unless I receive notification by e-mail that a course has been cancelled. It is my responsibility to check my e-mails, including my spam folder. If I do not show up, I agree to forfeit the full course fee. ______**(initial please)
I have added: info@equinerehab.ca to my addresses in my e-mail file. (This should prevent any communications from being sent to ‘spam’.)
I have read, signed, dated and have witnessed my waiver/release form which is found under the ‘application forms’ button as a separate document, and have included it in this package to mail, and if it is not included I understand that I must sign and have witnessed a waiver/release if I am to participate in this course. The date for the witness must match the date of the registrant. __________ **(initial please)
If the registrant is under 18, two (2) waiver forms need to be signed by the parent/guardian: the 2 page waiver and the ‘under 18 waiver’ – both are located under the application form tab.
I understand that it is highly recommended that I wear safety shoes. Any harm that may come to me if I choose not to wear safety shoes is my sole responsibility.
I understand that as we are working with horses, there is inherent danger in working with them, along with the dangers of working on horse properties, and I take full responsibility for my actions and further agree to follow all safety protocol as outlined in the course.
If I am bringing a horse to the facility, I am solely responsible for the safety and care of the animal, notwithstanding the rental agreement with the facility. I will make prior arrangements with the facility and I will bring sufficient hay for the horse during the course to help avoid colic from a change in feed.
Sidonia McIntyre and/or The School of Equine Massage and Rehabilitation Therapies will not be held liable for any expenses incurred to me should a class be cancelled either before or within the two weeks prior to the course start date.
As a minor cannot enter into a binding contract, a parent/guardian is required to sign for a minor. This contract will be between the parent/guardian and Sidonia McIntyre/ The School of Equine Massage and Rehabilitation Therapies. The course is a gift from the parent/guardian to the minor and the parent/guardian will be responsible for the payment of the course and is bound by the cancellation and refund policy. _______ **initial of parent/guardian
I take full responsibility for any injury I may incur during this course.
I take full responsibility for any damage I may incur to property at the facility.
Regardless of any areas on this form that indicate an initial, whether initialed or not, I agree to all terms, conditions and statements in this application form.
Signature ____________________________________________________ Date _______________
Parent/guardian if applicable _____________________________________ Date ______________
end of application form- cut here – do not scan or
send any pages below. This is information for your course for you to keep and read
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You should have approx. 4 pages to mail or scan. If you are missing 2 pages, it is most likely the waiver/release form. Click on the ‘application form’ button at the top of the web site. Directly under the application form link you will find the waiver/release link.
___________________________________________________________________________________________________________
Upon receipt of your application and payment, you will be sent an e-mail with the access code for the homework log in.
If the e-mail is returned as “undeliverable”, you will receive a text or phone call.
All classes:
Please print or take a picture of the ‘course locations’ page of the course you will be attending for full directions to the facility.
course location page can be located by following the tabs: course – massage – massage course locations – scroll down to the course location
Google and GPS are not 100% accurate – my directions are accurate
To locate your course, go to the ‘courses’ tab at top of the home page, scroll down to the course you are attending (massage, 6 week, or VR), then scroll over to the ‘course location” tab, then scroll down to your course location.
Please be sure to write down the date of the course. The correct dates are located on the application form, the ‘course locations’ page and the ‘course dates’ page.
My course date is: ________________________________________________
Please be at the facility on the first day of class, no later than 7:45am, so class can begin promptly at 8am. There are some locations that have a high traffic volume, so please leave early! Please do a ‘drive by’ of the facility the day before the class if possible.
Classes are from 8-5pm daily. The last day of class will be concluded by noon at the latest
The 6 Week Professional Program runs from Monday-Thursday 8am-5pm, Fridays 8am to no later than noon. There is one long weekend off to help prepare for the final week of presentations. This is on the last weekend of the course – week 5.
It is to be presumed by all registrants that the course is moving forward. If a class is to be cancelled, you will receive notification via e-mail.
A receipt will be issued on the last day of class along with the GST/HST #
Pack: a lunch, sunscreen, hat, cushion or towel for sitting upon – some people like to bring collapsible chairs. I provide plastic stools if there are no chairs provided by the facility, and they can get quite uncomfortable. Please also pack gloves in case of cold weather- the dollar store thin gloves are perfect for massaging in cold weather- thick or leather gloves are not acceptable for massage – extra clothing to be prepared for inclement weather.
Bug spray for yourself (and your horse if you are bringing your horse).
Although certainly not mandatory, it is always best to have your tetanus shot up to date as we do work in the barn – rusty nails and nips!
Although not mandatory, steel toed shoes/boots are highly recommended.
Everyone helps out with daily clean up of both the classroom and stalls/paddocks area. Many hands make light work! In all my years of teaching, I have always found each group to be ready and willing to lend a hand!
I do not allow video taping of the course or pictures of maneuvers, but you may bring your camera on the last day for group photos.
There is absolutely no smoking during class – this includes the new ‘smokeless cigarettes’, or vaping. You may smoke only in designated smoking areas – usually no less than 30 meters from the barn. In dry areas, smoking may only be permitted in your own vehicle. Proper disposal of butts is mandatory – no littering is permitted. Please carry gum or mouthwash as we do work in fairly close proximity to each other.
If you chew, spitting is not acceptable. A spit cup is also unacceptable. There is absolutely no spitting in stalls as nicotine is toxic to horses and nobody spits on the floors of the barn.
My cell #, to be used in case of emergency only -this means that you cannot find the facility on the first day of class or an emergency has arisen during the class – is 1-519-562-9992 . Please put this number into your cell phone contacts. I do not answer this phone while I am teaching. Any questions should be directed to either my e-mail (through the ‘contact’ section of the web site- this is best as the internet never sleeps and I can return e-mails at any time of day or night), or you may text my cell phone.
Hotel/Motel/Lodging is the responsibility of each student. Local hotels are typically listed with the Chamber of Commerce.
www.airbnb.com is an excellent source for accommodations – this is what I personally use. There are pictures of accommodations, along with the general area of the place. Once a person has booked the spot, then the address is provided.
www.kijiji.com is another resources for accommodations. If you google “short term accommodations (and the city name)”, then you will have multiple sites to choose from for your accommodation needs. Please be safe and take extra precautions when booking: Let someone know where you will be staying – full address and contact information of your host, take a picture of the house when you arrive and text it to a family member or friend. Try to find accommodations that will be reasonably quiet. Indicate that you are there to work (as some people do not take students) for the week and require a peaceful and quiet environment – you will need one!
If a course location page lists contact information of the facility, then you may contact that facility to inquire if you may bring your horse. If no contact information is provided, or the facility has already indicated that it is a ‘closed herd’, then you may not bring your horse to the course.
Any arrangements to bring a horse to a course is between the registrant and the facility.
No one ever needs to bring a horse to the course as all facilities provide horses for the course.
If you have made arrangements to bring your horse to the facility, then you must bring sufficient hay for your animal to help avoid a change in feed colic. You will be sharing your horse with the rest of the group as we work in pairs during the course. You will be working on your horse for the final exam. Your animal may or may not be used every day as this is would both annoy and fatigue the animal – so be prepared to work with other horses.
Please exercise care and caution when on facility property as there are dogs, cats, horses and people. Please obey the speed limit – if one is not posted, the accepted limit is 20km/hr.
E-mail is the best way to reach me. I check my e-mails no less than twice daily (unless I am traveling). You may send an e-mail by clicking on the ‘contact’ button of the web site, or e-mail directly to: info@equinerehab.ca E-mails are returned within 24-48 hours. If you have not received a reply, please check your spam folder.
Adding info@equinerehab.ca to your list of contacts will help ensure that e-mails come to the inbox.
Please do not leave a message on my cell phone as service can be very poor in some areas – texting to my cell is a much better form of communication; however, e-mail is always best.
website: www.equinerehab.ca