If you would like to send a donation, please fill out and print this form and send to:

Hearts and Horses
63 Justin Merrill Road
Buxton, ME 04093

Contact Information (leave blank if you wish to remain anonymous)
Street Address:
City:  State:   Zip: 

Choose a program:
$5,000 - Adopt a Horse Program  
$2,340 - Sponsor a rider for one year (1 lesson per week for 52 weeks)
$ 250 - Sponsor a therapy horse for one month
$ 45 - Sponsor a rider for one lesson
One time contribution in the amount of $ for the purpose specified below:
I would like to sponsor: (specific rider) for $
My company will match my contribution:

% Match:

I am sending $ to be used where it is most needed

Thank you!