Registration Form
Join me on a 7-week trauma-informed online series to connect with, tend to and heal our inner children together. Thursday Evenings: February 26 to April 9, 2026 from 7-8:30Pm EST. Online via Zoom.
Participant Name
*
First Name
Middle Name
Last Name
Gender
Pronouns
Do you identify as LGBTQIA+?
*
Yes, No, Ally, etc.
Where are you located?
E-mail
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example@example.com
Phone Number
*
Format: (000) 000-0000.
What is your age range?
18 to 29 years old
30 to 39 years old
40 to 49 years old
50 to 59 years old
60 to 69 years old
70 to 79 years old
80 to 89 years old
90+ years old
How do you identify? Check all that apply
*
Native American
Indigenous
Afro-Indigenous
African
African-American
Black
Asian
Pacific Islander
Asian American
Caribbean
Arab
Latinx
Caucasian
Mixed
Other
How did you hear about this series?
Friend/Word of mouth
Instagram
Email
Other
What is your intention in coming to this series? What do you hope to receive?
*
Do you have any access needs? Are there any accommodations that will make your participation more easeful and accessible? Do you have any questions, curiosities or concerns?
PLEASE SELECT. Click to select your option(s). If you are a person with privilege and means, please consider donating a scholarship or two. Scholarships will be made available to QT and BIPOC participants.
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Tending to Our Inner Child 7-week series
$111.00
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111.00
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Scholarship- Tending to Our Inner Child 7-week series
$111.00
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