Participant Acknowledgement This is an important form, which affects your legal rights and obligations. Please read carefully and do not sign it unless you are satisfied that you understand it. Wild Wisdom & Wellbeing – Nature Connection and Equine Assisted Learning (EAL) ACTIVITIES Nature Connection and EAL includes a variety of therapeutic and educational nature based activities, including but not limited to: Forest Bathing, Nature Therapy, Mindfulness with horses, Creative Arts, and guided wellbeing walks, for groups and individuals. These involve gentle, sensory based mindful invitations, reflective practices, and activities including; breathing deeply, walking slowly through nature and wooded areas, standing, sitting or lying down, and may be with or without the involvement of horses. The potential risks associated with this are; changing weather conditions, walking in nature, being near horses, and some natural hazards (eg. Exposure to ticks, trip hazards & branches.) Please give details of any medical conditions which may affect you, and of which the facilitators should be aware (e.g. asthma, epilepsy, diabetes, hearing problems, pregnancy, mobility difficulties or allergies). ACKNOWLEDGEMENTS I acknowledge and affirm that being in nature holds potential dangers, and that the natural world (and horses) can be unpredictable on occasions. I understand and acknowledge that I must strictly obey the instructions of the facilitators and must comply with any health and safety requirements. I understand that if I fail to comply with the rules and/or directions I may be injured or I may cause injury to others. Furthermore I understand that I will not be permitted to continue to participate. I agree to report any accidents, injuries, loss or damage sustained by me during any activity before I leave the site. I confirm that to the best of my knowledge all necessary and relevant information has been given to the Wild Wisdom & Wellbeing facilitator. Name* Email* Address* Emergency Contact Name:* Tel:* Relationship to you* Do you have any physical or mental health conditions?* Have you ever tried Nature Connection or Mindfulness before? What outcome would you like to achieve from this experience? Anything else I should know about? PARTICIPANTS AGED 18 YEARS AND OVER: I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD YOUR T&C’s, THIS AGREEMENT, THAT I AM TAKING PART IN THE ACTIVITIES VOLUNTARILY, AND THAT I FULLY ACCEPT THE RISKS INVOLVED IN PARTICIPATING. *I agree Submit
