Registration Form

Gender Diverse Group for Children

Name of Child(Required)

Please list your child's affirming name and pronouns (e.g. she/they).

Age of Child(Required)

Please list your child's age.

Name of Parent/Guardian(Required)

Please also share your pronouns, if you feel comfortable doing so.

Would you like to participate in the group for parents?

Yes

Email(Required)

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 to be added to Kindred Psychology's group email list.

Phone(Required)

Referral

If you were referred by a provider or community member, please list their name/organization here.

Consent

I agree to the website privacy policy found in the footer of this webpage.