Strengthening Families Program for Parents and Youth 10-14
This form is to show interest in taking part in upcoming cycles for the Strengthening Families Programs for Parents and Youth 10-14.

The Hampshire Gazette recently published an article on the program: http://www.gazettenet.com/Life/Easthampton-families-get-help-navigating-the-teen-years-751907

Questions about the program can be directed to coalition@epsd.us

Program Registering For
Name of Caregiver(s) Participating
Your answer
Contact Information for Caregiver(s)
Email Address and Best Phone Number to Reach You
Your answer
Home Address
Your answer
Name(s) of Youth Participating. Include Age, Grade, and School
Your answer
Names of Kids Needing Childcare. Include Ages
Childcare is available on site
Your answer
Food Allergies/Sensitivities We Should Know About
Your answer
Will You Be Attending Dinner Each Week?
Is There Anything Else That Would Be Helpful For Us To Know Before Starting The Program?
Your answer
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