Messy Hearts Circle
Home
How Circles Work
Attend a Circle
Meet the Host
FAQ
Registration Form – Jun 19, 2026
Friday, June 19, 10 a.m. – 12 p.m. EDT
Messy Hearts Circle is a small, facilitated group experience for people of all backgrounds who want a safe, non-judgmental space to reflect, share, and listen deeply. It’s a structured, confidential space for sharing and reflection using guided prompts and simple connection exercises. It is not therapy, not coaching, and not a support group. You’re welcome to participate at your own pace. No pressure to be eloquent, healed, or certain. Time commitment: 2 hours Location: Online via Zoom
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Meetup/ Luma name (if you RSVPed there)
Please enter the exact name used on Meetup or Luma so that we can match your reservation
in relevant Socials
Pronouns
she/her
he/him
they/them
other
prefer not to say
Email
*
Website / Socials
Country/ City / neighborhood
*
What’s drawing you to this circle right now?
*
Which themes feel most relevant for you lately? (Check all that apply)
Love / Intimacy
Loneliness / Isolation
Dating / Relationships
Expectations / Guilt
Identity / Belonging
Desire / Shame
Friendship / Community
Loss/ Grief
Fear / Vulnerability
Life transitions / Change
Group container agreements (Please check each box to confirm you understand the container)
*
I understand this is not therapy and not a crisis service.
I agree to confidentiality: I won’t share identifying details or personal stories of others outside the circle.
I agree to no fixing: I will not give advice unless someone explicitly asks for it.
I agree to speak from my own experience (“I” statements) and avoid generalizations about groups.
I understand participation is voluntary and I can pass on any prompt.
I agree to be respectful and consent-aware, including around sensitive topics (religion, sex, politics, trauma, etc.).
I agree to no recording (audio/video/screenshots) and to keep my phone away unless needed.
I agree to remain on camera during the session unless briefly stepping away when necessary.
Anything that helps you feel safe in group spaces? Anything that tends to make groups hard for you?
Do you feel able to participate in a group setting without needing immediate mental health support?
*
Yes
No
Hearing, online accommodation, or anything else we should be aware of?
*
Consent to be contacted via email about this event + future circles
*
— Select Choice —
Yes, you can contact me about this registration and future circles
Only about this specific event
How did you hear about us?
*
Submit
