Mental Health | Matatoa Counselling Services | TherapyHHMT Registration form | Matatoa

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Natasha Wakefield

Registered Psychotherapist

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Hold Me Tight with Horses
Registration Form

First name

Last name

Email

Your Phone number*

Birthday

Year

Month

Day

Address

What is your partner's name who will be attending with you?*

What is your partners email address?*

Partner's phone number*

What is your partners Date of Birth?*

Do you and/or your partner require any accommodations?

Do you and/or your partner have any food requirements or allergies?

My partner and I understand that this event is held outside and around horses

My partner and I understand that there are risks involved with interacting with horses, and take legal responsibility for those risks

12345 Side Road 17

Sunderland, Ontario L0C 1H0

Canada

Tel: 905-904-0038

matatoa12345@gmail.com

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Last name

Email

Phone

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