Equine-Facilitated Learning and Emotional Awareness Risks
Mandy Joy Wellness uses horses as part of educational, coaching, wellness, mindfulness, and personal development experiences. Horses are large, powerful, and unpredictable, which may result in risks.
Participant Information
Full Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Date
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Month
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Day
Year
Date
Emergency Contact Name
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Emergency Contact Phone
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Please enter a valid phone number.
Format: (000) 000-0000.
Risk Acknowledgment
Horse-Related Risks
I have read and understand the risks associated with horses and equine-facilitated activities.
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I have read and understand the risks associated with horses and equine-facilitated activities.
Emotional and Psychological Risks
I understand that these activities may be emotionally challenging and I am responsible for my own emotional well-being.
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I understand that these activities may be emotionally challenging and I am responsible for my own emotional well-being.
Service Scope and Treatment Clarification
I understand that services provided by Mandy Joy Wellness are not psychotherapy, counseling, or medical/mental health treatment and are not a substitute for such care.
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I understand that services provided by Mandy Joy Wellness are not psychotherapy, counseling, or medical/mental health treatment and are not a substitute for such care.
Assumption of Risk
I voluntarily assume all known and unknown risks associated with my participation.
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I voluntarily assume all known and unknown risks associated with my participation.
Final Consent Statement
Final Consent Statement
Consent
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I have read this agreement and agree to its terms.
Signature
Participant Signature
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Printed Name
*
Date
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Month
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Day
Year
Date
Parent/Guardian Name
Parent/Guardian Signature
Date
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Month
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Day
Year
Date
I have read this agreement and agree to its terms.
I have read this agreement and agree to its terms.
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