Friends Couple Enrichment - Registration Form
Use this form to register for the workshop being led by John and Debbie Humphries. You'll find more information about Friends Couple Enrichment at www.friendscoupleenrichment.org

February 1, 2020
9:00am-5:00pm (please plan to arrive at 8:30 to complete registration, get materials and settle in)
All Souls Unitarian Universalist Church
19 Jay St, New London, CT
Partner 1 First Name (name you want to be called) *
Partner 1 Last Name *
Partner 1 E-mail *
Partner 2 First Name (name you want to be called) *
Partner 2 Last Name *
Partner 2 E-mail *
Please provide a phone number where we can reach you, if needed. *
Where do you live (town and state)?
Have you ever participated in a Couple Enrichment event (or similar program) before? *
If you answered "yes", please tell us when you participated in that event (and perhaps a sentence about the experience).
How long have the two of you been together? *
What is the family constellation in your home? (e.g. children at home? blended family? caring for elders at home or nearby?) *
What are you hoping to experience during this event?
Friends Couple Enrichment workshops are open to people of all faiths and people who are not religious, but the workshops do have a "Quaker flavor." Please tell us what faith community (if any) you are part of.
Does either of you have physical restrictions we should be aware of (e.g., trouble with stairs, dietary allergies/restrictions, limitations with vision or hearing, etc.)?
Is there anything else that you think would be helpful for us, as leaders, to be aware of as we pray and prepare for this event? Anything you share here will be held in confidence.
CHILDCARE: All Souls Congregation will be providing free childcare for anyone who needs it. If you will be bringing children, please tell us how many children and their ages. All Souls will follow up separately to get more details about your specific needs.
The cost for the program is $50 per couple, payable by check or cash on the day of the event. ($20 is the fee specified by the Friends Couple Enrichment organization for a one-day program. The other $30 will cover food and materials for the day.) Scholarship funds are available for those who need them. If you are unable to cover the full cost, please specify how much you are able to pay in the "Other" field. *
Thank you!
We look forward to being with you on February 1st!

We will send additional logistical details during the week prior to the event.

With appreciation,
John & Debbie
jhumphries@igc.org; 860-216-7972
dhumphries@igc.org; 860-904-8428
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