FREE Lifetime Kindling Plan Membership Signup Form
Welcome Caring Parents! Bravo for taking this important step in optimizing your family's wellbeing!

Our mission is to make it easy as possible to access youth-centric wellness resources that are vital to helping your family flourish today!  

By signing up for our Kindling Plan, up to 6 of your family members will have access to our drop-in classes (live or on-demand), our "Daily Spark" motivational texting program, and our Library of Resources, all designed by School Counselors.

Please complete this form and our team will get your account set up for you and each of your family members. 

You'll then shortly receive a trio of communications from us:  
1.  account registration confirmation email to get you access to our platform.  
2.  email with our membership terms of use that will require your "digital signature"
3.  email & text with info on how to take full advantage of your membership.

Please check your spam filter if you don't notice any emails from us within 2 days. You'll be able to unsubscribe at any time to the text as well, but we hope you don't as they will be full of valuable positive messaging on raising healthy kids today!

Also please know that we take your family's safety and privacy seriously, and we will not, in any circumstances, share your personal information with other individuals or organizations.  We also strictly adhere to our Privacy Policy and we protect sensitive information with the latest encryption technology.

Please don't hesitate to reach out to us at: support@bonfiredw.org with any questions.

THANK YOU! 
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Name of School District *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent Date of Birth: We take the safety and privacy of you and your family and all of our members extremely seriously. We comply and adhere to the regulations of the Privacy Shield and Children's Online Privacy Protection Rule (COPPA) and we protect sensitive information with the latest encryption technology. *
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Mobile Phone #. Let's face it, we all read our texts more than emails and notifications. Our "Daily Sparks" programming sends multiple motivational and positive mindset texts per week to help keep your kids engaged and motivated. Again, we strictly adhere to our Privacy Policy and we protect sensitive information with the latest encryption technology. *
Mobile Phone Carrier.  This allows us to send email to SMS notifications to your phone to keep you updated on classes you registered for.  This is especially beneficial to increase engagement from students, as they view their incoming texts messages exponentially more than email or mobile app notifications.   *
Email *
City *
State *
How did you find out about us: Please share name of individual who referred you, or school district, Google, Linkedin, etc).   *
Family Member 1 first name
Family Member 1 last name
Family Member 1 Date of Birth (DOB):  We need this info to get your age verification of each of your family members so we can ensure the safest environment for all our members, particularly our youth members.  Again, we strictly adhere to our Privacy Policy and we protect sensitive information with the latest encryption technology.
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Family Member 1 email
Family Member 1 cell #
Name of School
Family Member 2 first name
Family Member 2 last name
Family Member 2 DOB
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Family Member 2 email
Family Member 2 cell #
Name of School
Family Member 3 first name
Family Member 3 last name
Family Member 3 DOB
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Family Member 3 email
Family Member 3 cell #
Family Member 3 name of school
Family Member 4 first name
Family Member 4 last name
Family Member 4 DOB
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Family Member 4 email
Family Member 4 name of school
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Family Member 4 cell #
Family Member 5 first name
Family Member 5 last name
Family Member 5 DOB
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Family Member 5 email
Family Member 5 cell
Family Member 5 name of school
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