Authentic Self Summer Series

Authentic Self Summer Series

Please fill out this information to sign up for the series
Student Information
Full Name

First NameLast Name
Parent/Guardian Full Name
Series I or II (4:30pm-6pm)
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
What is the student's favorite way to express themselves?
What helps the student feel safe and seen in a group?
Anything else the student would like to share?
Important Reminders
- Workshop is for emerging 6th, 7th, and 8th graders
- If not in middle school, students ages 11-14 may join
- Workshop is inclusive for students of all abilities who identify as female or non-binary
- Workshop is located at Merrick Pointe, 3850 Bird Rd Suite 403, Coral Gables, FL 33146
Agreements & Consent
I understand that all mental health professionals are mandated reporters and required to report abuse of a child, disabled, or elderly person. We are also required to report if your child is a danger to themselves or others.
I understand although the series is run by mental health professionals, it does not constitute a therapeutic relationship and is not a substitute for mental health treatment.
I understand the series will be run by a licensed psychologist and a registered mental health counseling intern under supervision. In the unlikely event of an absence, the group will be led by one facilitator.
I understand that in the unlikely event the series needs to be cancelled, I will be fully refunded as soon as possible. Otherwise, refunds are not available.
Please contact stephanie@authenticgrowthcounseling.com for any questions

Payment

Authentic Self Summer Series I (June-July)

Wednesday, June 17, 2026 at 4:30 PM - Wednesday, July 8, 2026 at 6:00 PM EDT 3850 Bird Rd 403 Coral Gables, FL 33146

$450.00

Authentic Self Summer Series II (July-Aug) - Stephanie Stillman

Thursday, July 16, 2026 at 4:30 PM - Thursday, August 6, 2026 at 6:00 PM EDT. 3850 Bird Rd 403 Coral Gables, FL 33146

$450.00

Authentic Self Summer Series (Open to Series I or II)

Wednesday, June 17, 2026 at 4:00 PM - Thursday, August 6, 2026 at 6:30 PM EDT 3850 Bird Rd Coral Gables, FL 33146

$450.00

Total

Credit Card

Should be Empty:

Authentic Self Summer Series

Student Information

Important Reminders

Agreements & Consent

Please contact stephanie@authenticgrowthcounseling.com for any questions

Payment*

Credit Card

Payment