Hope Group Registration - Spring 2026

Healing Hope Group Thursdays

6:30 - 8:30 pm EST Start Date: April 16th
Name*
Email*
Street Address:*
Apt or Unit #
City*
State*
Zip Code*
Phone Number*
YesNo
Confidentiality is essential for all Hope After Betrayal facilitators and group members to ensure a safe and respectful environment. What’s shared in the group stays in the group — with a few important exceptions: We are required to report any information that suggests abuse or harm involving a child, elderly person, or adult with disabilities; any illegal activity; or anything that poses a risk to someone’s safety. When required by law, Hope After Betrayal will report concerns to the proper authorities.Facilitators may also share limited information with Hope After Betrayal leadership for guidance and support when needed, but will always do so in a way that honors you and your confidentiality.*

I agree and commit to honor the confidentiality of all group members.
Yes - I agree to attend as consistently as possible.
Yes, I agree.
Yes, I understand.
Yes, I agree and understand.
YesNo
YesNo
IMPORTANT NOTE:

Healing Hope Group registration requires 2 STEPS.

1. Submit this intake form.

2. Once the form is submitted, payment options will be provided. Choose the option that works best for you and submit payment.

Your registration is not considered "active" until both steps have been completed.
Yes, I understand.
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