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Workshop Registration Form

Fill out the form below to book a session with Dr. Petties and start your journey towards empowerment and resilience.
Name E-mail Phone City & State
Workshop You Are Registering For
Freedom of Speech: The Responsibilities & Consequences of It
Thriving Minds (Adult Edition)
Thriving Minds (Youth Edition)
Male to Man: Becoming the Man You Were Created to Be
Purposeful Organizations
Battle Ready / Battle Tested
Other (please specify)
Message Workshop Date Workshop Location
Registration Type
Individual
Youth Participant
Parent / Guardian (for youth)
Organizational / Corporate Representative
Church / Faith-Based Organization
Are you attending as part of a group?
No
Yes — Small group (2–10)
Yes — Organization / Large group (10+)
If group or organization, name of group/organization
Youth Participants (If Applicable) / Is the participant under 18 years old?
Yes
No
Parent or Legal Guardian Name Parent or Legal Guardian Phone Number Parent or Legal Guardian Email Address hat are you hoping to gain from this workshop?
Have you attended our workshop before?
Yes
No
If yes, which one?
Do you require any accommodations?
Mobility accommodations
Hearing accommodations
Visual accommodations
Learning support
No accommodations needed
Other (please specify)
If other accommodations, please explain
Photography & Media Release Acknowledgment
I understand that photos and/or video may be taken during the workshop and may be used for Transcendestiny LLC promotional or educational purposes.
Acknowledgmen
I understand that this workshop may involve reflective discussion and personal growth activities. I agree to participate respectfully and responsibly.
Signature Date Submit

Transcendestiny LLC — Workshop Registration

Please complete this form to register for a Transcendestiny LLC workshop.
Your information helps us prepare an impactful, purpose-driven experience.
Name E-mail Phone City & State
Workshop You Are Registering For
Freedom of Speech: The Responsibilities & Consequences of It
Thriving Minds (Adult Edition)
Thriving Minds (Youth Edition)
Male to Man: Becoming the Man You Were Created to Be
Purposeful Organizations
Battle Ready / Battle Tested
Other
If Other → Go to Question 6
All others → Continue to Question 7
If “Other,” please specify Workshop Date Workshop Location
Registration Type
Individual
Youth Participant
Parent / Guardian (for youth)
Organizational / Corporate Representative
Church / Faith-Based Organization
If Youth Participant or Parent / Guardian
Otherwise → Continue to Question 10
Are you attending as part of a group?
No
Yes — Small group (2–10)
Yes — Organization / Large group (10+)
Group or Organization Name (if applicable)
Is the participant under 18 years old?
Yes ( Show Questions 13–15 )
No ( Skip to Section 5 )
Parent or Legal Guardian Name Parent or Legal Guardian Phone Number Parent or Legal Guardian Email Address What are you hoping to gain from this workshop?
Have you attended our workshop before?
Yes
No
If yes, which workshop?
Do you require any accommodations?
Mobility accommodations
Hearing accommodations
Visual accommodations
Learning support
Other
No accommodations needed
Please explain any accommodation needs
Photography & Media Release Acknowledgment
I understand that photos and/or video may be taken and used for Transcendestiny LLC promotional or educational purposes.
Participant Acknowledgment
I understand this workshop may involve reflection and personal growth activities and agree to participate respectfully and responsibly.
Electronic Signature (Type Full Name) Date Submit