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Equine-Partnered Play Therapy Workshop - January 24, 2020: Registration Form
Participant Basic Information
Indicates required field
Day Phone Number
Evening Phone Number
Do you have any physical limitations?
If yes, please describe:
Participant Relevant Experience
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.
Please list any relevant licenses and/or certifications that you hold:
Do you have previous training/experience in play therapy?
Are you a member of the Association for Play Therapy and/or a Registered Play Therapist (RPT)?
Do you have previous training or experience with equines?
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.
I further acknowledge and understand that Equine-Partnered Play Therapy must be be facilitated by a licensed mental health professional (or graduate-level intern under the supervision of a licensed professional) and an equine specialist.
I acknowledge and understand the above statement.
Please note that registrants will receive a full refund, minus a $10.00 processing fee, if cancelled up to 2 weeks prior to the training. Registrants will be refunded 50% for cancellations less than 2 weeks.
I understand and acknowledge the refund policy.
Submit Registration Form
After completing your registration, you will receive a follow-up email within 24 hours with a link to submit your payment. Please note: your seat at the workshop will only be reserved once payment is complete.
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