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Equine-Partnered Play Therapy Workshop: Registration Form November 18-19, 2017
Participant Basic Information
Day Phone Number
Evening Phone Number
Do you have any physical limitations?
Participant Relevant Experience
Please read the instructions by hovering or clicking the "?" icon before answering each section.
Your Primary Role:
Mental Health Professional*
*All Mental Health Professionals must be appropriately licensed to practice psychotherapy (or graduate students under the supervision of an appropriately licensed professional trained in play therapy) to practice EPPT. Please check with your state laws to make sure that you will be allowed to practice in your state. **All attending Equine Specialists must be either: (a) attending with a mental health professional, (b) already working with a mental health professional trained in play therapy, or (c) intending to begin working with a mental health professional trained in play therapy. Prior horse experience is required to be an Equine Specialist.
Mental Health Experience
Please describe any relevant experience working or volunteering with clients in a mental health setting. Be sure to highlight any previous experience, training, or coursework in Play Therapy.
Young Child Experience
Please describe any relevant experience working or volunteering with young children (3-10 years).
Please describe any relevant experience working with equines with an emphasis on groundwork.
By checking this box, I acknowledge that I understand that I will be required to complete additional forms upon arriving at the EPPT Workshop in order to interact with the equines and participate in demos involving equines.
I understand and acknowledge the above statement.
Register and Pay
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