Living Level 1 Oct 4-10, 2022- Registration Form
Thank you for your interest in the Graduates Only Living Level 1 training!  Once we receive your form and payment, you will receive a confirmation email, with training details to follow.

This is an advanced training and we want to make sure you're prepared.  
If we have any concerns based on your registration or intake form responses, we may reach out to you for further conversation.

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Email *
CONTACT INFORMATION
Full Legal Name *
Name you regularly use *
Pronouns
Gender Identity
Phone # / Whatsapp # *
Please include both numbers if they are different.
Name on Facebook
Link to your Facebook Profile page
ADDITIONAL INFORMATION
Birth Date *
MM
/
DD
/
YYYY
Nationality *
Where do you currently live? *
City, State/Province, Country
Emergency Contact Name and relationship to you
Emergency Contact Number
ISTA EXPERIENCE
Which Level 1 trainings have you participated in? *
Please let us know the year, location and lead facilitator for EACH Level 1 training where you have been a participant.
Have you taken Level 2? *
Have you taken the Practitioner Training? *
Have you taken Level 3? *
If you have assisted any trainings, please list the level, year, location, and lead facilitator for each.
How comfortable are you with the following tools and practices: *
Very comfortable/ A regular part of my life.
Somewhat comfortable/ An occasional part of my life.
Comfortable but not a regular part of my life.
A bit shaky/ I could use more work on this.
I never really got this one down.
Emotional Release Tools
Honoring Boundaries
Wheel of Consent (Giving, Receiving, Taking, Allowing)
Conscious Communication
Safe Sex Talk
Shadow-stalking (with sweetness, cunning, ruthlessness, patience)
FOOD AND ACCOMMODATIONS
Food Restrictions *
Meals will be delicious, healthy, vegetarian food with some meat options as well as vegan/gluten-free options. If you have special food needs or restrictions, please let us know below.  
Required
ACCOMMODATIONS OPTIONS
Most people will be in a twin bed in a room shared with 1-3 other people.  There is a choice of indoor accommodations in structures close to the training space or glamping tents shared with 1 other person in the middle of a beautiful meadow about a 5-10 minute walk from the training space (there is a shower house, wifi, electricity, and kitchenette in the camping area).  Glamping tents all include wifi, electricity, bedside heater and table with lamp, comfortable beds with mattress heaters and linens.

Single individuals or couples who would like a private space for an additional $300 (per room) will be added to a wait list.  We will know more about availability of this option closer to the training.   If a private space opens up for you, we will let you know and $300 will be added to your balance due.  

There are limited spots for camping with your own gear (5 available) and for RV's (4 available).  RV's must be 25' or less.  There are no hookups available.  If you bring an RV, you must let us know since space is limited and we will ask that you plan on not using a generator.  Camping spaces and RV spots will be prioritized for people with special needs.
ACCOMMODATIONS
PLEASE CHOOSE ALL OF THE FOLLOWING THAT APPLY:
Shared Bed Requests
If you intend to share a bed with a partner, please tell us their name.
Roommate requests
If there is someone going to the training who you would like to room with, please let us know their name and we will do our best to accommodate you.
Additional Accommodations requests/ comments.
Please include any special needs.  Also please let us know if you snore loudly.
TUITION
You can pay the full tuition at this time or you can pay a deposit of $500.  3% will be added to your payment to cover the credit card fees.  If you would like to pay with an alternative payment method such as Zelle, please click "other arrangement" and then contact us at ista@creatingcommunity.us for alternative payment options.

Your balance will be due 30 days before the training.  

Please let us know how much you intend to pay today *
Cancellation Policy *
Please confirm that you have read the cancellation policy here: https://docs.google.com/document/d/1GzJDGf2NcFyeLd1jaLnx8kiHMdnjsJNou161HBw69jk/edit?usp=sharing 
Required
Is there anything else you'd like to share?
Thank you for filling out this registration form.  We are glad you can join us!  After you click "submit", you will see the link to choose a payment method and make your payment.  We need to receive your payment before your registration can be processed.  Please contact Debby at ista@creatingcommunity.us or 716-479-1490 with any questions.
A copy of your responses will be emailed to the address you provided.
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