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West Coast Centre for Learning

Spring Equine Facilitated Wellness Program for Youth (Ages 8-12)

2/10 upcoming
Tuesday 4:30 PM - 6:00 PM
April 14, 2026, April 21, 2026, April 28, 2026, May 5, 2026, May 12, 2026, May 19, 2026, May 26, 2026, June 2, 2026, June 9, 2026, June 16, 2026

$1,495

$1,495 0% off
Pacific Riding for Developing Abilities
1088 208 Street, Langley, BC, V2Z 1T4
Pacific Riding for Developing Abilities
1088 208 Street, Langley, BC, V2Z 1T4

Participant

Minimum age 8 years, maximum age less than 12 years 10 months.

Health conditions *

Allergies *


Parent/Guardian

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You will receive your receipt by email.

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Emergency Contact


Other Parent/Guardian (optional)


Medical Questions


Family Doctor


Personal Health Number *


Does your child currently have a diagnosis? *

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Is your child on any medication? *

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Does your child have any behavioural concerns that we should be aware of? *

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School Information


Name of School Attending *


Is your child on a modified or adapted program? *

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What type of classroom setting is your child currently placed in? *

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The following questions will help us to understand how your child is coping socially. *

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What special interests or activities does your child engage in?


How did you hear about us? *

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I consent to having photographs and work samples of my child/ren used by West Coast Centre for Learning in promotional material. *

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Would you like to receive our newsletter with helpful parenting tips, program information, and special offers. (You can unsubscribe at any time) *

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Will you be accessing funding to pay for the program? *

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Please use the space below to share any questions, comments, or concerns you may have.


Parental Consent to Participate in the Program

I acknowledge that I am aware of the aims and structure of the program. I have had the opportunity to ask questions regarding the information provided and understand that I may seek clarification at any time to ensure my questions are answered to my satisfaction.

I understand that the personal information I provide will be kept confidential and used only for purposes related to participation in the program, in accordance with applicable privacy laws.


Equine Facilitated Wellness Program Statement of Agreement

Medical Release:
I, the undersigned, hereby declare that I am the parent or legal guardian of the child named above and that the information provided herein is complete and accurate to the best of my knowledge.

I authorize, in the event that all reasonable efforts to contact me or the designated emergency contacts listed above are unsuccessful, personnel of the West Coast Centre for Learning and Pacific Riding for Developing Abilities (PRDA) to seek and consent to medical treatment for my child by the physician identified above or, if unavailable, by another licensed medical professional.

I hereby release and discharge the West Coast Centre for Learning, PRDA, and their respective agents, employees, volunteers, and officers from any and all claims, demands, actions, or causes of action, whether known or unknown, which I, my heirs, executors, or assigns may have against them arising from or relating to any personal injury, illness, or medical treatment that my child may sustain while participating in the program or in connection with the provision of medical care.

I certify that my child is in good health and free from any communicable disease. I further certify that my child does not have any medical condition, injury, or physical limitation that would expose them to undue risk while participating in the program. Should my child have any such condition or injury, I agree to provide written notice to the program organizers prior to participation so that appropriate precautions can be taken to minimize risk.

By signing below, I acknowledge that I have read, understood, and voluntarily agree to this consent and release in accordance with the laws of the Province of British Columbia.

Health & Safety Measures
The health and safety of all visitors, employees, clients, and associates at Pacific Riding for Developing Abilities (PRDA) is our highest priority. If your child is unwell or exhibiting flu-like symptoms, please keep them home to protect the safety and wellbeing of all participants and staff.

Program Placement
Group placement is determined by qualified clinicians to ensure that the program is appropriate for each participant. Acceptance into the program is not guaranteed.

Payment
Payment is required at the time of registration for private registrations. For participants funded through the Autism Funding Branch (AFB) or a designated school, invoicing will be completed accordingly. If clinicians determine at registration that the program is not a suitable fit, a full refund will be issued.

Cancellation & Refund Policy
Participant placement is carefully considered to promote growth and a positive group dynamic. Cancellations can disrupt group cohesion and may, in some cases, result in the cancellation of a class, affecting all families. Please review program participation carefully before registering.

  • Cancellations made 30 days or more prior to the program start date will receive a full refund.
  • Cancellations with less than 30 calendar days’ notice will be subject to payment of the full program fees.
  • At the discretion of the Centre, participants may be allowed to transfer to a future session; however, no refund will be provided in such cases.
  • If program fees are being paid through external funding (e.g., school funding, Autism Funding, or third-party agencies), it is the responsibility of the registrant to ensure all fees are covered. Any portion not paid by the funding source remains payable by the family.

Statement of Understanding
I have read and understood the program description, policies, and procedures of the West Coast Centre for Learning and PRDA for the Equine Facilitated Wellness Program. I understand and agree with the philosophy and policies of the program and accept the terms and conditions set forth.

I acknowledge that failure to disclose pertinent medical, behavioral, or other relevant information may result in the removal of my child from the program.

Please read and scroll to the bottom to accept.


Electronic signature

Please sign your name inside the box
Signature pad
Signature pad

Thank-you for completing our Equine Facilitated Wellness Registration Form for Youth.

Upon submitting this form, you will receive a copy of your invoice and your responses.

Once you click "Continue", you will be redirected to our payment page. If you are accessing funding for payment, please follow the instructions below.

Please select "Autism/School/Other Funding" on the payment page, confirm which method of funding you will be using, then click the "I Confirm" button.

Thank you for choosing West Coast Centre for Learning, we look forward to connecting with you. If you require immediate assistance, please feel free to contact us: info@wccl.ca or (778) 839-5515.


By submitting this form, you consent to West Coast Centre for Learning collecting and using your information to respond to your inquiry. For details on how your data is stored and protected, please review our Privacy Policy.


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The Professional Centre, 3211 152nd Street, Building C, Suite 402, Surrey, British Columbia, V3S 3M1, Canada GST#797250032RT0001  778-839-5515

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