The Human Element® Program October 2024

The Human Element^® Program

October 14-18, 2024

Step 1 of 4

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company

Job Title

Email(Required)

Phone

Program Approach and Participant Expectations

By registering for The Human Element program, you understand and acknowledge that:

Participation in this program and in any of the activities is entirely voluntary. You are invited to participate and explore to the degree that you choose. You are in charge of your own experience and responsible for yourself.
The program's content and activities are offered to increase self-awareness, which provides information for you to make changes for yourself if you wish. Thus, the activities are for educational and informational purposes only and are not intended as any form of treatment, therapy, or advice for any health, emotional, mental, or physical issues.
The program leader(s) role is to create an environment for participants to increase their self-awareness and their awareness of others. They may ask questions or invite you to explore your own awareness at times.
The program is an intensive exploration of yourself. Please speak with us before you register if you have any concerns (physical, emotional, etc.) about participating in this program.
Given that people speak about their own personal situations in the program, we ask that you only speak to people outside the program about your own experience, both during and after the program. We ask that you not speak for others in the program and not speak about the experience of other people in the program. This is to ensure that each person in the program can choose what they share about themselves and their own experience as they see fit. You are welcome to convey what the facilitators of the program say and convey the program concepts.

Please let us know if you have any questions or concerns.

Attendees

Attendee 1's Name(Required)

Attendee 1's Email(Required)

Attendee 1's Phone(Required)

Address(Required)

Address Line 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 2's Name(Required)

Attendee 2's Email(Required)

Attendee 2's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 3's Name(Required)

Attendee 3's Email(Required)

Attendee 3's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 4's Name(Required)

Attendee 4's Email(Required)

Attendee 4's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 5's Name(Required)

Attendee 5's Email(Required)

Attendee 5's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 6's Name(Required)

Attendee 6's Email(Required)

Attendee 6's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 7's Name(Required)

Attendee 7's Email(Required)

Attendee 7's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 8's Name(Required)

Attendee 8's Email(Required)

Attendee 8's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 9's Name(Required)

Attendee 9's Email(Required)

Attendee 9's Phone(Required)

Address(Required)

Address 2

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies

Attendee 10's Name(Required)

Attendee 10's Email(Required)

Attendee 10's Phone(Required)

Address(Required)

Address 2(Required)

City(Required)

State(Required)

Zip Code(Required)

Special Requests/Food Allergies