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Affectionate Hands Leadership Summit - Attendee Registration Form

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Full Name *

Preferred Name *

Organization / Employer *

Job Title / Role *

Email *

Phone Number *

Payment Employer Attendance

Mailing Address

Attendance Option *

Day 1 – Opening & Keynotes
Day 2 – Workshops & Breakout Sessions
Day 3 – Leadership Labs & Closing Ceremony
Grand Gala

Preferred Breakout Track *

Preferred Breakout Track
Organizational Strategy & Innovation
Community Impact & Social Change
Personal Leadership Growth

Name (Emergency Contact) *

Relationship (Emergency Contact)

Phone Number (Emergency Contact)

Registration Type *

Early Bird
General Admission
Group Registration
Sponsored Attendee

Payment Method *

Credit Card
E-Transfer

Photography & Media Consent *

I consent to being photographed or recorded during the event.
I do not consent.

Data & Communication Consent *

I agree to receive event updates and communications from Affectionate Hands.

Redefining Leadership Through a Gender Inclusive Lens is a three-day leadership conference dedicated to transforming how leadership is understood, practiced, and experienced across various sectors.

affectionatehands@gmail.com

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