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Gender Diverse Group Series
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Registration Form
Gender Diverse Group - Teens
Name of Youth
(Required)
Please list your child's affirming name and pronouns (e.g. she/they).
Age of Youth
(Required)
Contact Name
(Required)
Parent/guardian consent to participate is required.
Parent/Guardian Email
(Required)
Enter Email
Confirm Email
Additional Email
If your teen would like reminders sent to them too, put their email here.
Enter Email
Confirm Email
Consent to Email
(Required)
Selecting this box confirms your consent to be added to our email list, specific to the gender diverse groups. No identifying information is accessible or visible to others. We utilize this list as a way to send out RSVP links and other group-related notifications.
I agree for the above listed email address(es) to be added to Kindred Psychology's group email list.
Phone
Referral
(Required)
How did you find out about the group?
What is your teen looking forward to most about this group?
Learning about resources
Developing social skills
Connecting with others like them
Consent
(Required)
I agree to the website privacy policy found in the footer of this webpage.
Name
This field is for validation purposes and should be left unchanged.