Unleash Part 2 Booking Form

Given Name *

Family Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Phone - ideally mobile. Note that this needs to be entered without spaces. Please include your country code (eg +44 for UK, +1 for US/Canada, +61 for Australia etc.) *

Have you already completed Unleash Part 1 (or Laurel Parnell's 3-day workshops in the UK pre-pandemic), or firmly booked to do so before doing Part 2?

Yes

No

Please confirm when you either did or are doing your Unleash Part 1/Parnell workshop. Note that you can register for Unleash Part 2 only after doing either Unleash Part 1, Laurel Parnell's full 3-day UK AF-EMDR workshop or are firmly booked to do Part 1 before joining Part 2.

For Unleash Part 2 (Intergenerational, Dreams, Parts intro), please choose from the following dates. All workshops £456 (or local currency equivalent).

Level of EMDR Training - Note that you cannot join our workshops/webinars unless you are fully trained in basic Standard Protocol EMDR. *

At least Part 3 (Part 2 in AU/NZ/US)

Accredited Practitioner

Accredited Consultant

Accredited Trainer

OtherOther

Where are you registered for tax purposes?

How did you hear about this Workshop? *

By registering for an EMDR Focus workshop, and recognising that participation can involve both observation and personal experience of sometimes profound trauma processing, I agree to take appropriate responsibility for my own emotional wellbeing, and to ensure I have access to any necessary therapeutic and/or supervisory support following the workshop. *

Yes

No

By ticking the Yes box below, I acknowledge that in managing this list, EMDR Focus Ltd will observe all requirements of GDPR.

Yes

No

Payment Options

I will pay immediately using credit/debit card, please take me to the necessary page.

I need a separate invoice for the organisation paying for this.

I wish to pay in instalments (by prior agreement only)

If requesting to pay in instalments, some words of explanation.

Credit Card