GriefShare RegRegistration Form and Group Guidelines on Confidentiality and Dating

Please fill out this registration form. Please read the Confidentiality Policy, the Dating Policy, and the Agreement. Then sign and date the form.

The cost of this 12-week program is $15, which pays for your workbook. (If you already have a workbook, you do not have to pay the $15). You can either bring your payment with you to the first session you attend, or you can send it to:

Ascension Lutheran Church
Attn: Brenda Lytle
1415 Dopp St.
Waukesha, WI 53188

If you have any questions, please contact Brenda Lytle, Director of Care Ministries, Brenda@ascensionelca.org.

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    Group Guidelines on Confidentiality and Dating

    CONFIDENTIALITY POLICY Your primary goal while attending GriefShare is to heal from the trauma of your loss. Because we want you (and everyone else) to be comfortable and to feel free to discuss whatever is on your mind, we ask that you adhere to the following guidelines while attending this group: 1. Never repeat anything discussed in the group. Discussing confidential matters with others can cause a great deal of distress and many times even bring undue emotional, legal, or physical harm. If we hear that someone is talking outside the group, that person will no longer be welcome. 2. Feel free to share your experiences, but refrain from giving advice, and limit sharing time to allow others the same opportunity to share. DATING POLICY 1. We do not allow dating within the group and strongly urge you to consider not dating at all during attendance of the GriefShare recovery program. 2. This is a time for healing and building emotional strength. If you are emotionally involved with someone of the opposite sex, your focus is not where it needs to be and this will affect your recovery. 3. We encourage you to make friends with those of the same sex and exchange contact information to support each other during this time. AGREEMENT I agree I will abide by the group guidelines and will not discuss anything shared in the group. I realize the importanceof respect when it comes to the confidentiality of others and cannot willfully expect them to keep my comments to themselves if I choose to openly discuss personal information outside our group. I also agree to not date anyone within my group and will consider not dating anyone while attending the GriefShare recovery program.
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