Name *

First Name

Last Name

Date of scheduled Forest Therapy walk *

MM

DD

YYYY

Would you like to be added to my email list to learn about future Forest Therapy opportunities with me?

I don't send many emails :)

Yes

No

Phone

I won't share this with anyone else! I like to have it to text you about last-minute walk reminders/details.

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Will you be comfortable doing a combination of slow walking, standing and sitting/laying on the ground? *

We typically spend the first 20-30 minutes sitting or laying on the ground, then do some slow walking on uneven dirt or mulched paths.

Yes. (You can skip the next question.)

No. (Please see next question.)

If you answered "No" above, will you bring a portable chair or something that will help you be comfortable?

If not, I'll do my best to make other arrangements for you!

Yes, I'll bring my own portable chair/stool/etc.

No, I'll explain what I need below.

Emergency Contact Phone #

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Photo/Image release *

Do I have your permission to take and potentially share photos of you on my website or social media? I typically only take photos from a distance or at times that will be least likely to distract you from the experience, and I do my best to share only flattering photos!

Yes you can take and share any photos you take of me.

You may only take non-identifying photos of me (e.g. from the back),

No you may not take or share any photos of me.

Waiver *

- I acknowledge that outdoor activities in natural areas entail known and unanticipated risks that could result in injury. - I agree and promise to accept responsibility for my own safety and well-being during this activity. I understand that I may at any time opt to not participate in any part of the activity should I feel that it is not safe, or simply that I do not want to participate in for any reason. - I voluntarily release and hold harmless Sarah Abu-Absi and the Association of Nature and Forest Therapy Guides and Programs (ANFT) and the individuals who are acting as guides on this walk from any and all claims of liability which are in any way connected with my participation in this activity. - If I have a medical condition or health concern that I think the guides should be aware of, I will inform the Guide before the walk.

Yes, I agree to the above conditions.

No, I do not agree to the above conditions.