Register for Resilience & Renewal Therapist Circle Name * First Name Last Name Email * Phone * (###) ### #### Session * For which session are you registering? Tuesday Session, October 10-November 14, 8:30-9:45 am Thursday Session, October 12-November 16, 7:00-8:15 pm Please let me know about future groups Payment I will pay $250 by September 25 I will pay $295 by October 3 I acknowledge that my registration is not complete until I submit payment to www.Venmo.com/liz-brekelbaum How did you find out about the group? Tell us a little bit about yourself! Where you work, what is going well for you right now, and what you are finding challenging. What do you hope to gain from participating in the Resilience & Renewal Therapist Circle? What questions do you have for us about the group? Thank you for registering for the Resilience and Renewal Therapist Circle!If you have no already, please send your registration payment to www.venmo.com/liz-brekelbaum If you have any questions, please contact Liz Brekelbaum (liz@evergreenrockford.com or 815-242-1213).Please note that this program is subject to cancellation if the minimum required number of participants is not met. Evergreen Counseling & Wellness is excited to provide this space for therapists, and, in order to create a valuable experience for all, it is essential that we have a minimum number of participants. If the program needs to be canceled due to insufficient registrations, registered participants will be notified in advance and provided with the option of a refund or credit towards a future class. We encourage you to spread the word and invite friends or colleagues who might be interested. Thank you for your understanding and cooperation.
