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Participation Form

Please fill out the following form
in order to participate in our activity.

Participant Information
Next of Kin Information
Parent / Guardian Consent

If participant is under 16 years of age

The above signed acknowledge that risks are involved in all outdoor and animal related activities and understand that Salta horses will provide a health and safety orientation to the environment to help mitigate the risks.  However, it is acknowledged that even with the orientation provided, animals can be unpredictable, and accidents can happen.  They agree to follow any directions given while onsite at the Salta Horses by the facilitators.

 

The above signed have been made aware that the sessions will be confidential, and any content shared in the sessions will remain confidential.  Content will only be shared for professional supervision or if required by the referring agency.

However, if the facilitators deem that there has been indicated or expressed risk to self or others, or by others during the sessions, that they reserve the right to inform relevant parties and agencies to help mitigate the risk. All written session notes will be filed and stored in a secure location.

 

The above signed have been made aware that sometimes working with animals in this context may  evoke a strong response and agree to seek the appropriate support within their existing or community supports. They understand that the facilitators are not available for crisis management outside of the sessions.

Thank you for completing your participation form.

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