Please submit the names of two people as professional references that you have known at least one year and to whom you are not related

Reference # 1

Reference # 2

List all schools attended and degrees earned:

Please list your short and long term goals related to Equine Sportsmassage:

Signing this application verifies that all information and questions have been answered truthfully. 

The Wilson Meagher Equine Sportsmassage Technical Practitioner Certification Program that we offer maybe considered physical and strenuous. We would like you to take a moment to check off any injuries or medical complaints/conditions that you may have now or have had in the past. Please be specific. 

Good health is essential in order to complete this program and remain safe with in the barns and around the horses.

I have been truthful and honest in answering the questions on this form. If my medical condition changes before attendance of the program, I will notify my instructors at once. I understand that if this occurs, I may need to acquire a doctor’s note to continue in the program.