EPPT Workshop Registration

Your Primary Role: *

Mental Health Professional* Equine Specialist

Please list any relevant licenses and/or certifications that you hold: *

Do you have previous training/experience in play therapy? *

Yes No

Are you a member of the Association for Play Therapy and/or a Registered Play Therapist (RPT)? *

Yes No

Do you have previous training or experience with equines? *

Yes No

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.

Equine-Partnered Play Therapy Workshop - January 24, 2020: Registration Form

Participant Basic Information

Participant Relevant Experience