COVID-19 Risk Assessment Form

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COVID-19 Risk Assessment Form

WETRA Participant*
First Name Last Name
Risk to Rider
1. Possibility of contracting COVID-19 despite infection control measures taken by Windsor-Essex Therapeutic Riding Association.
2. Potential to fall from horse despite safety measures and equine training taken by Windsor-Essex Therapeutic Riding Association.
Risk Potential*
Please check all that apply:
- is at higher risk due to having an underlying medical condition.
- is at higher risk due to struggles to maintain social distancing or in need of physical/hands on support by others.
- is at higher risk due to being unable to comply with wearing a mask.
- is at higher risk due to touching one’s face/mouth frequently, drools, etc.
- Risk to others (ex. Sneezing due to allergies, drooling, touching their/others face)
- None of the above apply.
Benefits to Rider
1. Provides general exercise and gentle cardio workout.
2. Provides sensory stimulation in a rhythmic way which modulates the sensory system that helps to calm the overactive areas and stimulate the underactive areas.
3. Requires rider to maintain midline and balance in response to each unique step of the horse, with the added balance challenges provided by games and/or riding skill challenges.
4. Works on social interaction, engagement and command following.
5. Provides an activity that can be customized based on needs and abilities on any given day.

Note: During COVID-19 pandemic, rider has fewer opportunities for social interaction, exercise, and cognitive challenge.
After assessing the risk/benefit specifically for the WETRA Participant named above and considering the WETRA infection control policies (masks, handwashing stations, social distancing), do you agree that the benefits outweigh the risks and that riding is appropriate at this time?*
- I agree
Parent Name*
First Name Last Name
Email Address*
Parent Signature*
8 + 1 =*
After entering the correct answer in the box above, the Submit button will appear.
Name
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