HALOS FEBRUARY VIRTUAL SUPPORT SESSION REGISTRATION
By submitting this form, you are registering for Halos February Bereaved Parents Support Session. Each session is held with a maximum of 6 parents and minimum of 2.

*Because Halos of the St. Croix Valley covering the cost of these sessions, your attendance is required. If for some reason you are unable to attend, you must notify us by Friday at noon, (February 7th), by Text: 1-866-411-4256 or Email: halosofthestcroixvalley@gmail.com is required.
Each box below must be checked stating you have read, understand and agree to all of the following rules: *
Required
Please select which meeting you would like to participate in: *
Last Name: *
Your answer
First Name: *
Your answer
Cell Phone Number where we can send a text alert: *
Your answer
SIGNED CONSENT FORM
All attendees must sign a consent form prior to them participating in their initial session. You will receive this at the email provided below. You will not have to sign the form for consecutive sessions.
*The consent form must be signed and sent back to halos prior to joining your initial support session
Email Address you'd like the meeting link sent to: *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy