Parenting AND Co-Parenting class registration fORM

Which class would you like to attend? If there are multiple classes, a separate registration form must be submitted for each class session. *

8 Week Parenting Class- begins Tuesday 8/24/21 6-8pm

6 Week Co-Parenting Class Men's Group begins Wednesday 9/29/21 6-8pm

6 Week Co-Parenting Class Women's Group begins Monday 9/27/21 6-8pm

*Is there a restraining order? (If there is a restraining order parents will be in separate zoom meetings throughout the entire 6-week program.)

Yes

Attorney Information (if applicable)

Your Name: *

Please indicate if the other parent will be participating in the program and provide their name below.

Please take a moment to tell us a little about yourself.

There is a one time $45 intake/registration fee that must be paid in advance.
Each session is $35 and must be paid in full prior to the first day of class.

If court involved, when is your next hearing?

Are you involved with Child Welfare Services? (CPS?)

Yes

If yes, please enter your social workers name and phone number?

Email: *

Phone *

Address

Parenting AND Co-Parenting class registration fORM

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Locations in riverside

and san diego county

PHONE: 951.249-3816

or 619.483-1035