National Day of Racial Healing - Racial Healing Circle Sign Up Form
Healing circles are geared toward bringing together individuals from varying backgrounds to a space to discuss personal racial narratives to provide insight, understanding, and appreciation of one another’s struggles. This experience is meant to recognize past and current truths about trauma and harm that racism has caused, both individually and collectively. Through narrative sharing, we are working together towards trust, connectedness, forgiveness, balance, and wholeness. Healing Circles provide the opportunity to engage the heart through genuine honesty and openness to listening to the truths of peers. Ultimately, through authentic narrative sharing, this transformative experience reaffirms the humanity in all of us.

Please note that this is a first-come, first-serve basis; each healing circle will have a capacity of 20 individuals. For each healing circle session a meal will be provided. It is expected that each individual is to stay the entire duration of the racial healing circle.



Date: Tuesday, January 21, 2020

Time:
Morning Session: 8:30 AM - 12:00 PM
Afternoon Session: 12:30 PM - 4:00 PM

Location:
601 W Maple St, Kalamazoo, MI 49008

Name *
Your answer
Email *
Your answer
What time would you like to participate in the racial healing circle? Each session will include a meal and participants are expected to stay the entire duration. *
Do you have any dietary restrictions?
Your answer
Do you need any special accommodations that we should be aware of?
Your answer
What do you hope to gain from the racial healing circle? *
Your answer
Age
Race
Your answer
Personal Pronouns (i.e. She/Her/Hers, He/Him/His, They/Them/Theirs)
Your answer
Have you ever participated in a racial healing circle?
Do have any questions?
Your answer
Additional comments or notes for the facilitator
Your answer
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