Thank you for submitting the registration form below. The registration form is the same for each group, so please be sure to indicate which one you are interested in signing up for. Please complete the * sections to provide the information needed for your registration. The rest of the questionnaire is optional, however, your willingness to complete it will help me know you better. Your participation in the group requires the submission of The Daring Greatly™ Questionnaire and The Daring Greatly™ Consent Form. These may be electronically submitted or mailed to me at Sarah Perl, LCSW-R,  291 Wall Street Suite 3R, Kingston, NY 12401. Please contact sarahperl@resilientselftherapy.com if you’d like a printable registration form. Confirmation of group enrollment will not occur until your payment is received.

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