Strengthening Families Program (10-14) Registration
Welcome to Strengthening Families 10-14! This is a program about showing love and setting limits.
WHO: Parents/caregivers and youth ages 10-14
WHERE: First Presbyterian Church, 252 College Ave, Beaver, PA 15009
WHEN: Beginning Wednesday, Oct. 27th at 5:30pm. Continues on the same night and time for the following 6 weeks!
Please answer all required questions. A confirmation email will be sent to you when your registration is submitted.
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Does this phone number allow for text messages?
Parent/Caregiver Name(s) who will be attending
Additional Youth(s) who will be attending (provide name and age)
What school district does your child attend or do you live in?
What is the best way we can contact you?
Will you and/or your child need any special accommodations (learning disabilities, etc)?
Do you have other children younger than the age of 10 in which you would like materials to keep them occupied during program time frames? If so, please provide name(s), age(s), and other necessary information.
Please provide any additional information necessary that will be important for us to know during the programming.
How did you hear about us?
Friend or Family Member referral
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Keystone Wellness Programs.