Thriving Families Support Registration

THRIVING FAMILIES SUPPORT GROUP

Do you want to better understand why you and your kids react the way you do to each other?

Do you want to connect with other parents and families that are going through similar experiences?

Are you interested in how childhood experiences affect your children as they grow?

IF YES, THIS GROUP IS FOR YOU!

Masks are optional. They are recommended for unvaccinated individuals. We have extras if you forget yours and want one. We strongly encourage everyone who is eligible to be vaccinated for Covid-19. If you need information about that please ask your Thrive coach.

FREE 2 night support group for families working with a THRIVE coach, hosted by Heart of Indiana United Way.
- Time: 5:15pm-7:30pm
- Dates: Monday, July 18 and Tuesday, August 9, 2022
- Location: South Meridian Church of God, 2402 Meridian Street, Anderson, IN 46016
For THRIVE participants who have at least one child ages 0-18 years old/senior in High School.
For your children, ages 0 to 18 years old/senior in High School
SUPPORT GROUP includes the following:
- FREE meal for the whole family.
- Session for parents/caregivers led by qualified facilitator and childcare for children.

I would like to register for:

Thriving Families Support Group on Monday July 18
Thriving Families Support Group on Tuesday August 9

Adult Contact Information

Name *

Phone

Coach's Name *

May we contact you if we need to for details related to this registration? *

What is your preferred mode of contact?

Children Attending

Please provide information on any children you will be bringing with you so that we can be sure to have enough food and age appropriate activities.

Child 1 Name

Child 1 Age

Child 1 Grade

Child 2 Name

Child 2 Age

Child 2 Grade

Child 3 Name

Child 3 Age

Child 3 Grade

Child 4 Name

Child 4 Age

Child 4 Grade

Child 5 Name

Child 5 Age

Child 5 Grade

Emergency Contact

Name *

First

Last

Relationship to your child(ren)

Phone *

Other Information

If there are any safety issues we should be aware of for you or your child, please provide some information about the issue if you can.

Does anyone in the family attending have any food allergies, sensitivities and intolerances? *

Does anyone in the family have any other (non-food) allergies or have any special needs (medical, mental health, social, etc.) that require attention? *

THRIVING FAMILIES SUPPORT GROUP

Adult Contact Information

Children Attending

Emergency Contact

Other Information

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