Name *

First Name

Last Name

Phone *

Primary Contact Number

(###)

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Acknowledgement *

I recognize I am attending as a professional. I plan to attend all sessions in order to protect group cohesion. I agree to use information obtained ethically. I acknowledge this training does NOT permit me to train other professionals in TBRI, advertise myself as a TBRI professional, nor advertise myself as being trained in TBRI.

I agree.

I do not agree.