Daring Greatly™ and Rising Strong™ Group Registration
I am so glad you are considering participating in these groups! It is a brave step, and an important choice to invest in yourself.
I appreciate you taking the time to fill out this application for registration.
Submitting your interest does not commit you to the group at this time, nor does it guarantee a spot.
With this, I will try to confirm your spot in the group as soon as possible, by contacting you for quick consult, if necessary and secure payment/deposit. Deposit $50.
I am interested in the following: Check any that apply. Confirmation of spot in group will follow.
Daring Greatly™
Rising Strong™
Name
Email
Note: Your email is used to confirm your identity in our client registration process.
Mobile
What sparked your interest in this workshop, and what would you like to achieve as a result of participating?
What concerns, if any, do you have about participating in a group experience? How do you think you would respond if someone dominated the conversation, or never participated in group discussion?
Do you have a therapist you could work with if something came up in this workshop that required individual attention?
Yes
No
No, but please refer someone for me
Is there anything else you would like me to know?
How did you hear about this group?
REGISTER ME! I want to Dare Greatly and Rise Strong!