Building Bridges Workshop Registration Form
Thank you for your interest in attending Building Bridges: Grow Together and share Cultural Experiences!

Date: Monday, August 26, 2024
Time: 6:00-8:00 PM
Location: Gale Presbyterian Church, 10 Barnswallow Dr.,  Elmira
Fee: NO COST
In Partnership with: Grace Ibrahima and Rick Csiernik
Dinner will be served
Open to the Public

Join us for a powerful and engaging workshop with authors and diversity advocates Grace Ibrahima and Rick Csiernik!
 
Here's what's in store for our workshop:
•  Experience Grace's inspiring journey through racism, resilience and hope, and gain valuable insights from Rick on the mental and social impacts of racism.
•  Engage in interactive activities that promote empathy and unity as you explore diverse experiences and privileges.
•  Cap off the evening with a delicious meal and meaningful conversations. Be part of this transformative event!

Registeration deadline is August 12.

Kindly inform us if you require any transportation or have other requests to facilitate your attendance at the workshop.

Let's foster a welcoming and inclusive community together!

Please fill out this form to register for our workshop.
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Name *
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What city do you live in? *
Please indicate how many people, including yourself, will be attending the workshop.
Dinner and beverages will be served. Please let us know if you have any dietary restrictions. *
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Our programs are fully inclusive. We have zero tolerance for misconduct, including harassment, bullying, abuse or assault, illegal activity, intoxication, discrimination and plagiarism.

We are committed to providing a safe, respectful, and inclusive space for all participants. By attending, you agree to abide by the following code of conduct:

Respect and Inclusivity: Treat everyone with respect and kindness, regardless of their gender identity, sexual orientation, race, ethnicity, age, disability, or any other characteristic. Embrace diversity and appreciate the unique perspectives each participant brings.

No Discrimination: Discrimination, harassment and negative behavior will not be tolerated.

Language: Be mindful of the language you use. Refrain from using offensive or inappropriate language, slurs, or derogatory terms. Use gender-neutral language when possible, and refer to the person using their pronouns as noted on their nametag.

Open-Mindedness: Approach discussions with an open mind and a willingness to learn. Listen actively and consider diverse perspectives. Avoid making assumptions about others' experiences.

Confidentiality: What is shared in our safe space should stay in our safe space. Respect the privacy and confidentiality of others. Do not share personal stories or information without explicit permission.

Consequences: Violations of this code of conduct may result in removal from the location of the program. We reserve the right to refuse entry to or remove any participant who does not comply with these guidelines.

By attending, you acknowledge that you have read, understood, and agree to adhere to this code of conduct. We appreciate your commitment to creating a positive and inclusive space for all participants.

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Thank you for signing up to Building Bridges: Grow Together and share Cultural Experiences! We look forward to seeing you.
A copy of your responses will be emailed to the address you provided.
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