Hold Me Tight, Let Me Go Workshop Family Registration

Please complete the adjacent form to register for the upcoming Hold Me Tight® Let Me Go Workshop. Please read all policies on payment and cancellation by clicking the link: here.

After submitting your registration form, you’ll be contacting by one of the facilitators to coordinate payment and to hold your spot.

Parent/Guardian's Name

First Name

Last Name

Additional Parent/Guardian/Support Person's Name

First Name

Last Name

Child's Name

First Name

Last Name

Child's Age

Parent/Guardian's Email

Additional Parent/Guardian/Support Person's Email

Parent/Guardian's Phone Number

(###)

###

####

Additional Parent/Guardian/Support Person''s Phone Number

(###)

###

####

Full Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Full Mailing Address (if needed)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How did you hear about this Workshop?

Tell us about your interest in this workshop, what do you hope to learn or gain through this experience?

Have you ever participated in any other groups or retreats before? What was your experience like?

Do you or your child have any dietary restrictions or requests?

Is there anything you'd like us to know about you or your child?

Have read and agree to all policies

See all policies here www.allisongrubbs.com/hold-me-tight-let-me-go-policies

Yes

Once you submit your registration, you will be contacted directly by Allison to arrange payment.