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My Hurts Group Registration Form

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My Hurts is a faith based confidential peer support group dedicated to the process of healing from unhealthy relationships,
trauma, or substance abuse.
Join us as we encourage one another towards healing and deliverance!

 

The King's Daughters Ministry Hurts Group REGISTRATION FORM

Please complete the registration form below and click "SUBMIT" at the end.

You will receive an email confirmation receipt of your registration.

If you do not receive a response from our office within two business days,
please contact us at 704-263-4204.

Contact Information
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First Name
Last Name
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All minors must be accompanied by parent or guardian.
AVAILABLE GROUP OPTION(s)
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Choose One
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SPECIAL ACCOMODATIONS
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