September-October 2024 SEL Groups -Registration Form
Be Well with SEL, LLC offers Social Emotional Learning (SEL) enrichment lessons in a small group format to participants. Each class includes stories, discussions, games, videos, movement activities and/or crafts all relating to SEL skills. Skills and strategies taught are educationally based "enrichment programs" and are not individual treatment plans or a form of therapy for students. Participants must be able to follow Be Well with SEL's "Code of Conduct" that is written into the Client Agreement Form. 

SEL groups offered include:
-SEL lessons aligned with at least one of the 5 core competencies of SEL (self awareness, self-management, social awareness, relationship skills, responsible decision making)
-“Take Home Note/Packet” after each class that includes skills taught and language used for carry over at home

Payment:
The total cost of the SEL group session is $300 (5 week/60 minute groups and 6 week/45 minute groups cost the same). Please note that Be Well with SEL, LLC does NOT accept insurance. Payment is accepted in the form of cash, check made payable to "Be Well with SEL, LLC", or Venmo @KristenPerrotti (last 4 digits are 6671 if Venmo requests it). If paying by check, please mail to:

Kristen Perrotti
Be Well with SEL, LLC
800 Turnpike Street, Suite 300
North Andover, MA 01845

A 50% non-refundable deposit ($150) is due at the time of submitting this registration form. Please note that spots will be held for 5 business days only. If the deposit is not received by the 5th day, the spot will be released for another student to register. The remaining $150 tuition balance must be paid PRIOR to the start of the first day of class.
*If a registration needs to be cancelled, the deposit will be kept on file as a credit to use towards any future SEL group, camp, or workshop.

*Be Well with SEL, LLC also offers a $50 sibling discount if registering for a SEL class during the same session. A $50 discount is also offered if registering one child for two SEL groups during the same session.

AFTER SUBMITTING THE REFERRAL FORM, YOU WILL RECEIVE AN E-MAIL CONFIRMATION (within 24 hours) FROM KRISTEN STATING THAT YOUR CHILD IS REGISTERED FOR A SEL GROUP. IF YOU DO NOT RECEIVE CONFIRMATION AFTER 24 HOURS, PLEASE E-MAIL: kperrotti80@gmail.com
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Which group are you registering your child for? *
Participant Name *
Participant Age *
Participant Grade *
Address *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian E-mail *
Emergency Contact Name AND Phone Number *
Please provide any additional information you feel might be helpful to know about the participant
Has the student ever participated in a group with his/her school counselor? *
If YES, please provide details
How did you hear about Be Well with SEL, LLC? *
"Code of Conduct" and Client Agreement Form: *
Required
*PAYMENT AGREEMENT: By checking the box below, you agree to pay 50% of your child's group fee at the time of submitting this registration form.

The remaining 50% is due on or before the 1st class.

Please note that spots will be held for 5 business days only. After the 5th day, the spot will be released for another student to register.
 *
Required
Payment Method: *
AFTER SUBMITTING THE REFERRAL FORM, YOU WILL RECEIVE AN E-MAIL CONFIRMATION (PLEASE ALLOW 24 HOURS) FROM KRISTEN STATING THAT YOUR CHILD IS REGISTERED FOR A GROUP. IF YOU DO NOT RECEIVE CONFIRMATION AFTER 24 HOURS, PLEASE E-MAIL: kperrotti80@gmail.com
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