Horse Powered Reading Interest Form Parent/Guardian Name * First Name Last Name Child's Name * First Name Last Name Email * Phone (###) ### #### Child's Grade * Kindergarten First Second Third Fourth Fifth Sixth Tell us about your child's strengths and interests! * Tell us about any delays or learning struggles your child has. * By typing my name I agree to allow my child to participate in Justin's Place Horse Powered Reading program. I consent to my child's picture being taken for marketing purposes through Justin's Place. I consent to share testing score information pertinent to their reading skills. * Thank you!
