TEEN Stable Ground — Registration

Stable Ground: Teen Edition — Registration

An evening for teens in nature & community
Join Us for Stable Ground - A Chance for Women to Slow Down

Held at Pony Power Therapies · 1170 Ramapo Valley Rd, Mahwah, NJ - Stable Ground brings teens (ages 13-17) together in this grounding setting to slow down, practice attunement, team building skills, and communication skills. No horse experience is needed, just a willingness to show up as you are. Come breathe a little deeper, soften a little more, and leave feeling more steady than when you arrived.
Participant Information
Full name

First NameLast Name
Email
example@example.com
Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact/Person Completing Form
Emergency contact

First NameLast Name
A few logistics
Have you (the participant) spent time around horses before?
Please share any allergies, diagnoses, disabilities, or needs your child has (be as detailed as possible)
Anything else we should know or that you woud like to ask before you arrive? What are you hoping to experience or gain from your participation? Are there any concerns about your child's behavior and ability to participate safely? (NOTE we do ask that participants in attendance be able to attend the event independently/without a caregiver present due to staffing ratios at this time)
Participation
Registration payment
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January 21st
Stable Ground — Registration

$40.00 Quantity

July 15th
Stable Ground — Registration

$40.00 Quantity

Total

$0.00
Before you go
Acknowledgement of supportive community format and facilitator roles
Safety acknowledgement for horses and working farm
Privacy acknowledgement
Photo consent

I acknowledge that photos of me or my likelness may be captured at the event by facilitators or other participants and these may be used in promotional materials about future group offerings or by participants to share their experience at the farm; by attending this event/group I express my consent for this unless I have made other express, written arrangements with A Work of Heart Counseling and Pony Power Therapies.
Future events and resources updates
I consent to my minor child (under 18) participating in this event and will provide transportation TO AND FROM Pony Power Therapies for this event.
Name

First NameLast Name
Signature
Participants MUST complete the below liability waiver prior to clicking "Save my Spot" and submitting this form: https://www.ponypowernj.org/liability-form
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
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Stable Ground: Teen Edition — Registration

Join Us for Stable Ground - A Chance for Women to Slow Down

Participant Information

Emergency Contact/Person Completing Form

A few logistics

Participation

Registration payment

Before you go

Participants MUST complete the below liability waiver prior to clicking "Save my Spot" and submitting this form: https://www.ponypowernj.org/liability-form

Payment Methods