Registration for the December 3-5 Workshop

Online – Live
December 3-5, 2021
Celebrating Connections: An Introduction to Hakomi Mindful Somatic Psychology

Faculty: Gregory Gaiser, PC, Certified Hakomi Trainer
Hours: Friday, Dec. 3: 5-7 PM; Saturday and Sunday, Dec. 4 & 5: 11 AM-4 PM with an hour break each day
Please note: all times are Mountain Daylight Time.
Cost: $275 if paid by Nov. 22, $325 thereafter (includes a $75 non-refundable deposit & admin fee)
CEs: 10 CE hours. Meets CE requirements for Texas LPC, LCSW, and LMFT (please check with your state’s regulations for reciprocity)
Please note: This workshop fulfills the prerequisite for the Hakomi Southwest Comprehensive Training

Registration

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*Are you a student?
NoYes

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*Are you taking the workshop as (check one or more):
A prerequisite for the Hakomi Therapy TrainingA therapist or practitioner interested in learning more about HakomiFor personal growthFor other reasons (describe below)

If taking the workshop for other reasons, please describe:

*How did you hear about the Hakomi Therapy? (Check one or more)
Hakomi Institute WebsiteHakomi EmailPsychotherapy Networker: (Website, print magazine or conference?)Friend/ReferralOther (describe):

*CE’s requested:
NBCCSocial workerMFT (NBCC)Professional counselor (NBCC)No CEs requested

*Are there accommodations you require to make the workshop accessible?
NoYes
If you require accommodations, please describe

*How do you identify yourself to others? i.e. is there anything you want our teaching team to
know about your *social location, cultural identity, or other group membership (and optionally)
that could help you participate more fully in the training? *An individual's social location is
defined as the combination of factors including gender, race, social class, age, ability, religion,
sexual orientation, and geographic location. This makes social location particular to each
individual; that is, social location is not always exactly the same for any two individuals:

What other information would you like to share about yourself?

*By typing my name here, I agree to pay for the entire workshop whether or not I attend both
days. Refunds only on cancellations made at least 72 hours prior to workshop (less $75
registration fee)