Revival Red Dust Healing Women's Yarning Circles

Revival Registration

Developed in partnership with Marymead, Revival is a grassroots program that aims to bring together the communities of the Eurobodalla Shire impacted by the Black Summer bushfires. Revival will support these communities with a collection of Cultural & wellbeing support programs to build a shared story of healing, survival and regeneration.

This service is supported by funding from COORDINARE –South Eastern NSW PHN through the Australia Government’s

PHN Program. While the Australian Government helped fund this document, it has not reviewed the content and is not responsible for any injury, loss or damage however arising from the use of or reliance on the information provided.

Should you have any questions or need help, you can contact the Tamara on 0475 013 605 or tamara@familyplace.org.au

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* 1. What is the participant's full name?

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* 2. What is the participant's address?

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* 3. What is the participant's date of birth?

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* 4. At what email address AND phone number can the participant be contacted?

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* 5. Please select which Yarning Circle location and dates you would like to participate in.

Soul Space, Batemans Bay 12th August

Soul Space, Batemans Bay 19th August

Tomakin Community Hall 9th September

Tomakin Community Hall 16th September

Moruya Mechanics Institute 23rd September

Moruya Mechanics Institute 7th October

I’m not available for these dates or locations, but would like to kept informed of future dates and locations of workshops.

Tuross Head 14th October

Tuross Head 21st October

Bodalla Hall 4th November

Bodalla Hall 11th November

Tilba Hall 16th November

Tilba Hall 17th November

Revival Red Dust Healing Women's Yarning Circles

Revival Registration

Question Title

* 1. What is the participant's full name?

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* 2. What is the participant's address?

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* 3. What is the participant's date of birth?

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* 4. At what email address AND phone number can the participant be contacted?

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* 5. Please select which Yarning Circle location and dates you would like to participate in.

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* 6. Please provide an emergency contact name and phone number.

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* 7. Do you have any other feedback, questions or comments to provide? Please explain below.

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* 8. Please advise how you heard about this project.