Messy Hearts Circle
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Registration Form – May 30, 2026
Saturday, May 30, 5–7 p.m.
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 in person. Location: Prospect Park, Brooklyn, NY
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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
Pronouns
she/her
he/him
they/them
other
prefer not to say
to most box
Email
*
Phone number (Optional, but recommended for day-of logistics)
Website / Socials
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 the space’s Code of Conduct and their shoes off policy
See more information about the Code of Conduct and space policies on the FAQ section of the website.
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
Mobility, hearing, scent sensitivity, seating accommodation, pet allergies, or anything else we should be aware of?
*
Consent to be contacted via email and/or text 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?
*
Payment
Price:
$25.00
Click submit to reveal the payment link. Save $10 instantly: Use Early Bird code EB53026 at checkout by May 23rd.
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