Registration Register for the workshop: TEAM CBT Business Track - ONLINE training We will meet online, LIVE three Fridays: May 19, June 16, and June 30, from 8:30 am PDT to 12:30 pm PTD / 5:30 pm CET to 9:30 pm CET. We are offering the program in Polish and English. Cost: $297 Requires: TEAM-CBT level 1 "*" indicates required fields Email* First Name (given name)* Last name (surname)* What pronouns do you use?* She/her He/him They/them Prefer not to say Other Degree*(eg. Ph.D., Psy.D., M.D., M.A., other) Country* City* Phone*With your country prefixI agree to add the above phone number to the WhatsApp group - for quick communication* Yes No I am a TEAM-CBT therapist at level 1 or higher* Yes No Profession* What therapy modalities/approaches do you use?(mark all that apply) CBT TEAM CBT Schema Therapy ACT Interpersonal Psychodynamic Systemic Integrative Gestalt other If invoice required, please enter necessary data here tax ID is necessaryDiscount codeIf you have a discount code, enter it below Additional Information you want to share Consent*I agree to the processing by Fundacja SIZ z siedzibą w Lublinie(20-152) ul. Sekutowicza 3/9 of my personal data provided in this document for conducting this conference pursuant to the Personal Data Protection Act of 10 May 2018 (Journal of Laws 2018, item 1000) and in agreement with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation). I agreeConsent to use the image*whereas: -Fundacja Simontonowski Instytut Zdrowia with its seat in Lublin, at street Sekutowicza 3/9, 20-152 Lublin, entered into the National Court Register under the number KRS 0000318444, NIP 9462569414, REGON 060430107 (hereinafter: the Foundation), organizes the TEAM CBT Online Training on May 19 - June 30, 2023 (hereinafter: the Training); -I am a participant of the Training; -for the purposes of promoting the Training, as well as for educational purposes, the Training will be recorded (hereinafter: Recording) and promotional photos will be taken (hereinafter: Photos); I give the following consents regarding my image and personal data: 1. I consent to the Foundation for recording, filming and photographing me during the Training in order to make the Recordings and Photos. 2. I consent to the Foundation for the dissemination of my image and statements in the recorded materials contained in the Record and in the Photos in order to create training materials, without time and territorial limits, in the following scope: on television, radio, press and other printed materials and on the Internet (from including YouTube and social networking sites), as well as for granting further permits by the Foundation in this regard. 3. I give the Foundation consent to the processing of my personal data in connection with my participation in the Recording and in the Photos. 4. At the same time, I acknowledge the following information in which I am referred to as “Participant”: a) The administrator of the personal data of the Participant is the Simontonowski Instytut Zdrowia Foundation with its seat in Lublin (ul. Sekutowicza 3/9, 20-152 Lublin) (hereinafter also: “Administrator”) b) The participant may contact the Administrator in any case regarding his personal data: by phone, by correspondence or by e-mail to the address firstname.lastname@example.org c) data will be processed to the following extent: necessary to grant this consent and necessary to participate in the Recording and in the Photos (i.e. image, including voice). d) Personal data will be processed in order to implement the Recordings and Photos for the promotion of the Training and also for the educational purposes of article 6 sec. 1 letter a) and article 9 sec. 2 letter a) EU Regulation 2016/679 on the protection of personal data (hereinafter:”GDPR”) in connection with article 81 of the Copyright and Related Rights Act, fulfill the legal obligations incumbent on the Administrator (Article 6 (1) (c) of the GDPR) and in the legitimate interest of the Administrator, i.e. for promotional purposes and pursuing possible claims pursuant to article 6 sec. 1 letter f) GDPR. e) The image of the Performers may be used in the Administrator’s external and internal materials (including: on websites, social media, printed materials) and in entities cooperating with the Administrators. f) Personal data will be stored for the period of using the Record and Photos. g) Providing personal data is voluntary, but necessary for the Participant’s participation in the Training. h) The Administrator may engage external entities to process the Participant’s personal data (e.g. entities conducting postal or courier activities, entities purchasing receivables, banks, subcontractors providing IT support services, marketing agencies, etc.). i) The participant has the right to request access to his personal data, rectification, deletion, limitation of processing and their transfer. The participant has the right to lodge a complaint with the President of the Office for Personal Data Protection (ul. Stawki 2, 00-193 Warsaw), to object to the processing of data and to withdraw the consent granted for data processing at any time. j) Participants’ data will not be transferred outside the EEA and will not be covered by the profiling mechanism. I consent to the use of my image in accordance with the information contained above.Where did you learn about this training?*(mark all that apply) word of mouth direct invitation a Facebook post a Facebook ad LinkedIn post LinkedIn ad email other Please Specify* What is/are your biggest professional/business challenge(s) right now?* PhoneThis field is for validation purposes and should be left unchanged.