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Play Therapy - Children
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Equine-Partnered Play Therapy Workshop - November 18-19, 2017: Registration Form
Participant Basic Information
Indicates required field
Day Phone Number
Evening Phone Number
Do you have any physical limitations or food allergies?
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.
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.
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 and an equine specialist.
I acknowledge and understand the above statement.
Please note that registrants will receive a full refund, minus a $15.00 processing fee, if cancelled up to 6 weeks prior to the training. Registrants will be refunded 50% for cancellations less than 6 weeks.
I understand and acknowledge the refund policy.
Register and Pay
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