Emergency Contact Information:
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Name | Relationship | Phone Number:
DEPARTURE Flight Information:
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Airline | Flight Number | Date | Time | Departure Airport
ARRIVAL Flight Information:
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Airline | Flight Number | Date | Time | Arrival Airport
Dietary Restrictions:
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Please list any dietary restrictions or meal preferences.
How do you envision using the skills and knowledge gained from this experience in your future teaching or facilitation work?
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Teaching and Facilitation Goals
How do you manage your own personal growth and emotional regulation in challenging situations?
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Self-Reflection and Growth
What are some wonderful or difficult things about your PAST experiences with sexuality and sensuality you want me to know?
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Sexual and Prior Trauma History
Have you experienced any kind of sexual abuse or trauma aside from anything mentioned above? If yes, please share what you would like Veronica Clark to know. Trauma can result from various occurrences, including surgery, childbirth, car accidents, and witnessing violence. These experiences can stay lodged in our body and create blocks that prevent us from living a full life. Feel free to share anything you believe will be helpful to instructors as an effort to co-create the most loving and safe space for all participants.
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Sexual and Prior Trauma History
