BRAVE SPACE: Conversations Registration
Please fill out one registration form PER ATTENDEE. Contact secretary@immanuel-ucc.org with questions.

BRAVE SPACE: Conversations is special community program to help us get to know our neighbor, end division, display empathy, and stop judgement. Join us for activities, story-telling and special guests (and food of course)!

Sharon Mast, highly sought-after professional facilitator & coach, will lead us with her trademark ENERGY, humor, and honesty through BRAVE SPACE: Conversations.

Details:

*  DATES: Sundays, 9/19, 9/26, 10/10 & 10/17  
We hope you can join us for all four sessions; however, you are welcome to attend when available. We encourage you to attend the first session, 9/19, and at least one other session; but you can attend just one.

*  TIME: 3:00 - 5:00 p.m.

*  WHO: Ages 15 to 115. All whom are open to learning how to build a better community are welcome to attend. Encourage your friends, family, neighbors, and coworkers to register and join us. Program is based on respect not religious experience or affiliation.

*  WHERE:  Fellowship Hall of Immanuel United Church of Christ’s campus at 99 S. Waverly Street, Shillington

*  COST:  FREE to register and participate

(The funds for this program were awarded by the Hawley & Myrtle Quier Fund of Berks County Community Foundation as part of the $100,000 “You Are Here” Berks program. The goal of this special grant for non-profits is to foster human connection in our community. Projects that breakdown polarization, create a sense of shared community, highlight different points of view, and showcase a variety of voices were prioritized for selection.)
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Attendee FIRST Name (please fill out one form for each attendee) *
Attendee LAST Name (please fill out one form for each attendee) *
DATES ATTENDING
This program runs for four (4) Sundays  - September 19, September 26, October 10, and October 17 (NO program on 10/3).
Please check EACH date you plan to attend in the following four boxes below. Do not check if you can not attend.
Yes, I plan to attend on:
Yes, I plan to attend on:
Yes, I plan to attend on:
Yes, I plan to attend on:
(Optional Question)     IF there is enough interest, IUCC MAY provide trained childcare to eliminate attendance barriers. If childcare would allow you to attend more sessions or allow your partner to also attend, please let us know below.  Provide details including age(s) of child(ren) and which session childcare would be needed. You will be contacted ONLY IF there is enough interest.
Attendee's Email *
If under 18 only, Parent/ Guardian Phone Number (for emergency contact use)
We would like to take photos for marketing purposes. Do we have your permission to share photos on social media pages and BRAVE SPACE advertising? *
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