Healing the Bonds of Attachment - Booking Form To book for one of our Workshops / Courses please fill in the form below.Date of Workshop / Course *Saturday 15th October 2016Full Name *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabwePhone Number *Email Address *Date of Birth *dd/mm/yyMedical Conditions Any medical conditions we need to be aware of?Dietary Requirements Additional Info Anything else you feel we may need to be aware of?Payment Full payment is due within 3 days of booking to reserve your place on the Workshop / Course. For any queries please contact us.Cancellation Policy To cancel a place on Equine Therapy Center Workshops and Courses, notice of cancellation must be given by email to info@equinetherapy.center If you cancel at least 28 days prior to the start of the course you will receive a full refund minus a 10% administration fee. If you cancel less than 28 and at least 10 days prior to the start of the Workshop/Course you will receive a 50% refund. If you cancel less than 10 days prior to the start of the Workshop/Course you will not be entitled to a refund. No refund will be made for non-attendance on the course. In the case of a Workshop/Course cancellation you will either be offered an alternative date, a credit note or a full refund. *Occasionally circumstances will arise which result in the need to cancel, reschedule or postpone Workshop/Course, due to an unforeseen occurrence. When this is the case Equine Therapy Center shall assume no liability.”Please tick box to confirm payment and cancellation policy. *I understand and have read the payment terms and cancellation policy. VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: