Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Payment Amount
*
prev
next
( X )
USD
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Policy Acknowledgement
*
Policy Acknowledgement
*
Registrant Agreement
*
I have read and agree to the following:• This book study is a wellness and educational discussion group and is not psychotherapy, counseling, or mental health treatment.• Participation does not establish a therapist-client relationship with Marnie Stanton, LCSW or Dragonfly Springs Counseling & Wellness.• The facilitator will guide discussion of themes from the selected book, but individual clinical assessment, diagnosis, or treatment will not be provided.• Participants are responsible for determining whether this group is a good fit for their personal needs and circumstances.• Participants are encouraged to respect the privacy and confidentiality of fellow participants. While confidentiality cannot be guaranteed in a community setting, all participants are expected to treat personal information shared by others with respect and discretion.• Participants are expected to contribute to a respectful, inclusive, and supportive discussion environment.• Registration fees are non-refundable within 5 days of the start of the series, except in the event of cancellation by the organizer.• Participants understand that the purchase of the book is their responsibility. • By registering, participants acknowledge that they are voluntarily participating in this educational wellness program.
Submit
Should be Empty: