Daring Way Registration — Sadie Forsythe, LICSW, CDWF Psychotherapist (770)676-1879

Daring way™ Workshop Registration

A Four Part Mini workshop Series:

Sept 16, Sept 30, Oct 21, & Oct 28, 2018

The Daring Way™ is a highly experiential methodology based on the research of Dr. Brené Brown. Together, we will explore topics such as vulnerability, courage, shame, and worthiness. You will be invited to examine the thoughts, emotions, and behaviors that are holding you back and identify the new choices and practices that will move you toward more authentic and wholehearted living.

I look forward to the time we will share together for this workshop series. Your responses to this brief form will help me prepare for our time together, and will be held confidentially.

Name

First Name

Last Name

What’s your current familiarity (if any) with Brené Brown’s research & writing?

What would you like to accomplish as a result of attending this workshop? What are your hopes for our time together?

What concerns, if any, do you have about participating in this workshop?

Is there anything you want me to know about you (including your current life struggles or personal history) to best support you in our time together?

Payment: I understand that my individual fee is $115. Online payment for this event is no longer available, I will submit my payment by mail to complete my registration. I will have the option to pay in full now, or to pay half now and pay the remaining half at the first workshop.

I Agree

Participation Agreement: I agree to take care of myself while I participate in this workshop. I understand that workshop participation is not the same as nor intended to replace individual therapy and I will seek additional support should the need arise while I participate in this workshop series. I understand my participation in this workshop is voluntary and I have the right to withdraw at any time, though I will not receive a refund for partial participation and will make an effort to attend all sessions if possible. While this is a workshop rather than therapy, I understand that our facilitator, Sadie Forsythe, is a licensed therapist and as such will hold any sharing that occurs within our workshop in strict confidentiality, with the exception that she is a mandated reporter for any disclosure of imminent threat to harm self or others, or abuse/neglect of children, the elderly, or people of disabilities.

I Agree

Signature

Date

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