Activities may include:

• Approaching, observing, and interacting with horses on the ground
• Grooming, leading, feeding, and caring for horses
• Participating in structured exercises and activities designed to build awareness, communication, emotional regulation, and resilience
• Engaging in individual or group discussions, reflections, and wellbeing practices facilitated by qualified staff
• Being present in an outdoor farm environment, which may involve uneven ground, natural obstacles, and exposure to weather conditions
• No horse riding takes place. All interactions are ground-based.

• Physical, bodily, or psychological injury or death
• Physical exertion beyond my accustomed level
• Failure of equipment or use of inadequate equipment
• Inadequacy or absence of treatment or transport facilities if injured
• Varying conditions without warning
• Injury to others or by others

I may be injured or die due to the Provider’s negligence, breach of contract, or breach of statutory duty or guarantee.

I acknowledge that the activities are recreational and involve significant physical risk.

I understand the Provider is not liable for the actions of other participants.

By signing, I acknowledge that the risks have been explained, that I undertake them voluntarily and at my own risk, and that this “risk warning” conforms with the Civil Liability Act 2002 (NSW and WA).

¹ The “Provider” includes officers, employees, agents, contractors, franchisees, and assigns.² “Activities” includes all associated/before-and-after services—such as transportation, inductions, training, manuals, equipment familiarisation, etc.

• Horses are large, powerful, and unpredictable animals that may react suddenly to movement, sound, touch, weather, or other animals.
• Risks include being bitten, kicked, struck, trampled, stepped on, pushed, knocked down, or injured by sudden movements of a horse.
• Risks may arise from leading, grooming, feeding, or interacting with horses on the ground, as well as from being in close proximity to horses during group or individual sessions.
• These risks exist regardless of my level of experience or the precautions taken by the Provider and its staff.

I understand that while the Provider takes all reasonable steps to create a safe environment, it is not possible to guarantee complete safety when interacting with horses.

By signing this form, I voluntarily assume and accept all such risks of injury, harm, or damage arising out of my participation in equine-assisted activities with the Provider.

• Follow all Provider rules and instructions
• Use/wear any equipment given by the Provider
• Be medically and physically fit to participate
• Disclose any pre-existing medical or other condition that could impact safety
• Notify the Provider of any injury, illness, or concern during the activity
• Refrain from reckless, negligent, or foolish behaviour that may harm myself or others
• Accept evacuation, first aid, or medical treatment at my expense, and consent to such treatment
• Confirm I have not consumed alcohol, mind-altering substances, or medication that impairs judgment or capacity

• Release, waive, discharge, and hold harmless the Provider (and its employees, agents, directors, officers) from any claims for personal injury—regardless of cause (negligence, wilful act, breach of contract, statutory duty, error, etc.)
• Indemnify the Provider against any such claims

You may be agreeing to exclude or modify your rights to sue for services that did not meet statutory guarantees

This applies in QLD, NSW, WA, TAS, NT, ACT, and at the Commonwealth level

Exclusions may apply even if injury results from breach of implied warranties under Civil Liability Acts

South Australia

Under sections 60–61 of the Australian Consumer Law (SA), statutory guarantees apply to services being rendered with due care, fit for purpose, and achieving expected results.

Providers may ask you to agree to exclude these guarantees.

A child under 18 or their parent/guardian cannot legally do so.

More info: ocba.sa.gov.au

Victoria

Statutory guarantees under the Australian Consumer Law and Fair Trading Act 2012 (Vic) are in place (due care, fitness for purpose, results).

Section 22 allows providers to ask for exclusion of these rights—but only if not due to gross negligence.“Gross negligence” means reckless disregard for consequences. See regulation 5 and section 22(3)(b).

Cancellation Policy

We understand that sometimes plans change, and it may be necessary to cancel or reschedule your appointment. We kindly ask for as much notice as possible.

Cancellations made less than 48 hours before the appointment time, or failure to attend without notice, will incur the full session fee.

This policy allows us to manage our schedule effectively and offer the time to other clients who may be waiting for an appointment.

Purpose of Counselling

Counselling provides a confidential space to talk through concerns, build coping skills, and work toward agreed goals. Sessions may include conversation, grounding exercises, nature-based activities, or equine-assisted work depending on the client’s needs.

 

Informed Consent

By signing this form, you confirm that:

You understand the nature and purpose of counselling.
You may ask questions at any time.
You may withdraw from counselling at any point.

 

Consent for Note-Taking

Your counsellor keeps brief, factual session notes to support continuity of care.

Notes include relevant observations, goals, and progress.

Notes are stored securely following the Privacy Act 1988 and the Australian Privacy Principles.

You may request access to your notes, except where restricted by law (e.g., safety concerns or legal matters).

Notes must be kept for a minimum of 7 years, or until a young person turns 25, depending on state legislation.

 

Consent for Supervision

To maintain professional standards, counsellors are required to participate in clinical supervision.

- Your case may be discussed with a qualified supervisor (therapist).
- Your identity is kept confidential (only de-identified information is shared).
- This improves service quality and is an ACA requirement.

 

Mandatory Reporting – Understanding the Limits

If your counsellor forms a reasonable belief that:

- A child is experiencing abuse, neglect, or serious harm, or
- Someone is at immediate risk,
the counsellor is legally obligated to make a report to Child Protection or other appropriate authorities.

You will be informed whenever possible before a report is made, unless doing so increases risk.

 

Confidentiality

What you share in counselling is private. Your information and notes are stored securely and are only used for the purpose of providing counselling.

However, confidentiality has limits. Under Australian law and the ACA Code of Ethics, counsellors must act to protect client safety.

Information may be disclosed without your consent if:

1. There is a risk of harm to you or someone else.
2. A child or young person is at risk of abuse or neglect (mandatory reporting).

Mandatory reporting is a legal requirement when there is reasonable suspicion of abuse or harm.

3. A court subpoenas counselling notes.
4. It is required by law to protect wellbeing or safety.

 

Privacy & Data Protection

Your personal information is collected for the purpose of providing counselling services.
In line with the Privacy Act 1988 and ACA guidelines:

- Information is stored securely (digital and/or locked physical storage).
- Only relevant information is collected.
- You may request correction of inaccurate information.
- Cybersecurity standards (password protection, device security, secure storage) are followed.

 

Fees, Non-Attendance & Cancellation

Sessions are billed at the agreed rate (NDIS or private).
Cancellations with less than 48 hours' notice may incur the full session fee.

 

Client Rights

You have the right to:

- Be treated with dignity and respect.
- Receive services free from discrimination.
- Ask questions or provide feedback.
- Request a change of counsellor.
- Decline any intervention.
- Withdraw from counselling at any time.

I have read the information or it has been read to me and I understand the information stated above. I understand the potential risks, benefits, my rights in participating in this form of therapy. I have had the opportunity to ask questions and the answers were discussed to me clearly, understandably, and to my satisfaction.

For Participants Under 18 

As a parent/guardian with legal responsibility, I certify that I acknowledge, understand, and accept all the aboveI consent to this release and indemnify the Provider—even if arising from the Provider’s negligence