Nurtureways · Finding Calm Registration Family Camp Discount

Discount Code

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This Registration form is for Type 1 Families, please use discount code from Camp or email jamie@nurtureways.org if you are part of the T1D community for the code

Contact Information

Name

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First Name

Last Name

Email

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Verify Email

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Phone

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To be used for pre-group contact call

Relationship Status

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Partner's Name (if applicable)

First Name

Last Name

Will you be registering as a couple/attending together?

Yes

2nd attending parent email

Verify Email

2nd attending parent phone number

Ok to receive text communications

Yes

Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Child's Information

Child's name

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Child's Date of BIrth

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Child's Sex at Birth

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Ages of other children in the household (if applicable)

Additional information about your family

Please feel free to tell us any additional information you would like to share about your child or family

Family Photo

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Please upload a picture of you and your family that you are willing to share with the group

Class Registration

How did you hear about Finding Calm?

Which Group are you Registering for

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For Parents of Children 6 months – 6 years old: Tuesdays, 10/4 – 11/8 | 12:00-1:30pm

For Parents of Children 6 months – 6 years old: Tuesdays 11/15-12/20 | 12:00-1:30pm

For Parents of Children with Chronic Illness (all ages): Wednesdays, 10/26 – 11/7 (no mtg 11/23) 6:30-8:00pm |

For Parents of Children with Autism and Developmental Disorders (all ages): Mondays, 11/7 – 12/12 | 9:30-11:00am |

Registration Type

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$175.50 - Family Camp Individual Parent

$265.50 - Family Camp Discounted Couples Rate

What are you hoping for from participation in this group?

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Legal Disclaimer:
Withdrawal from a Group: Due to limited class space and payment holding your spot, we cannot issue a refund if you decide to withdraw from a group after the point in time that is 7 days prior to the group starting.

Consent: Participation in this group is voluntary and not a substitute for mental health treatment. In the case of an emergency, contact 911. Virtual groups may utilize non-HIPAA compliant platform(s) which include potential risks, included interruptions, unauthorized access, and technical difficulties.

Confidentiality: No information about you is released from Nurtureways or to anyone without your written permission, except as required by law or court order. We are required by law to report suspected child abuse (regardless of when it occurred), elder abuse and clear, concrete evidence of planned acts of violence.

Registration Agreement

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I understand and accept these terms of registration