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Spring 2022 Virtual Workshop Registration
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Email
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Email Address:
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Participant Name:
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Date of Birth (of participant):
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Phone Number:
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Address (include city and zip):
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Which workshop(s) would you like to register for?
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04/09/22: Seriously Scatterbrained: Strategies to Improve Your Child’s Organization & Attention
04/23/22: Yes, You Can! Understanding and Changing Problem Behavior
05/14/22: Hurting & Afraid: Riding the Emotional Rollercoaster
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How did you hear about this workshop?
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I am aware that this is not treatment for any specific mental health disorder, but an educational workshop.
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Yes, I understand
What you are hoping to learn as a result of your participation?
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Any and everything! I have little to no knowledge about this topic.
A few more tools for my toolkit; I know a fair amount of information about this topic.
New and refreshing ideas; I have done my research and tried everything, but nothing has worked.
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Please list any specific questions for the workshop facilitator:
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Age of your child/children:
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Birth to 5 years
6 years to 10 years
11 years to 14 years
15 years to 17 years
18 years+
Other:
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Child(ren)'s School of Attendance:
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Have you or your child(ren) accessed other services at Waypoint Wellness Center?
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