Free to Be Equine Center Certified Equine Facilitated Learning Owner - Jamie Schnabel

Equine Facilitated Learning INFORMED CONSENT FOR SERVICE

In order to provide you with the best possible service, the following policies have been outlined for you. Please read them carefully, and sign below indicating your acknowledgement of the information and acceptance of the terms for service.

Equine Facilitated Learning includes a combination of observations and activities with horses as well as skill development such as; professional, social, emotional, behavioral, life, and personal. Horses are sentient beings, and are interested in relationships, provide feedback, and present opportunities to learn about yourself. All activities will be restricted to the ground. These activities takes place outdoors(a barn, pasture, or round pen It is important to wear shoes that will protect your feet and appropriate clothing. As there is no formal waiting room, please remain in your car or away from the entrance to the barn in order to provide privacy to other participants. There is additional paperwork specific to this process that you will need to include:

Waiver of Release and Liability Emergency Contact Information Emergency Medical Preferences

Any information you provide, or records we maintain, are kept strictly confidential. Exclusions that specifically apply to the equine program:

Any other instructors, volunteers, interns or staff may need limited client information to provide for session effectiveness and/or safety. Any staff or volunteers are trained and supervised regarding confidentiality.

The physical facility is not enclosed, and participants may be viewed from the road or surrounding environments.

Other staff or volunteers from the facility and/or program may have need to come to the facility during our appointment times; although every effort is made to prevent this from happening, there is no way to guarantee absolute privacy, especially in case of emergency.

Free to Be Equine Center Certified Equine Facilitated Learning Owner - Jamie Schnabel

Equine Facilitated Learning - Special Forms

Safety for participants, staff, horses and anyone else is of primary concern and Jamie Schnabel is committed to operating in a manner consistent with that concern. Consequently, Free to Be Equine Center and Jamie Schnabel's horses meet the industry standards and Jamie Schnabel is a HERD certified Equine Facilitated Learning Specialist. Nonetheless, there are limits inherent in any animal-assisted program. Wisconsin State Statutes are posted on the premises. Participants and their guardians are encouraged to read them.

Conditions of Nature: Neither Jamie Schnabel nor Free to Be Equine Center are responsible for partial acts, occurrences, or elements of nature that can scare a horse, cause it to fall or react in some unsafe way. Some examples are lightning, thunder, weather, wild or domestic animals, etc.

LIABILITY RELEASE AGREEMENT AND CONSENT TO PROVIDE SERVICE

desire to participate in equine facilitated learning. I acknowledge the risks and potential risks of equine-assisted activities. However, I believe that the potential benefits to myself/my child are greater than the risk assumed. I hereby, intending to be legally bound for myself, my heirs and assigns, executors and administrators, waive and release forever any claims for damages against Jamie Schnabel and Free to Be Equine Center, staff, instructors, Board of Directors, for any and all injuries, losses that I or my child may sustain while participating in equine assisted activities with Jamie Schnabel.