Family Grief Series Registration Form

Family Grief Support Series

Brighter Days Family Grief Center
Winter 2026 Family Grief Support Series
Monday evenings 6:30 pm - 7:30 pm
January 12th - February 16th

Hosted at: Virtual via Zoom

We are pleased that you are joining us for our Family Grief Support Series. This weekly series is for grieving youth (5-17), young adults (18-27), parents, grandparents, and other extended family members. *Please note that one parent/guardian must attend the adult sessions for youth under 18.

Our group leaders are trained volunteers who are experienced in facilitating group discussions while providing resources and healthy coping skills for you and your family. They do not provide grief counseling at any time. If you would like to discuss grief counseling options with our master level grief counselors, please contact us.

Youth and Young Adults will be placed in age-appropriate groups to share about their loved one. Adults will connect in one group to share about their loved one while gaining valuable education on how best to support the grieving youth and young adults they are caring for.

If you are attending a virtual series, each family member participating will need access to an electronic device such as a desktop computer, laptop computer or tablet.

Brighter Days reserves the right to determine participant readiness before and during the program to ensure participants are getting the proper support. For inclement weather, all in-person sessions will be held virtually.
Adult Participant 1 (at least one adult must attend each adult group session if youth are under 18).*

First NameLast Name
Adult Participant 2

First NameLast Name
If you are a parent/guardian, please note relationship to youth participant(s) *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Children's Information:

This section is for youth ages 5-17. If you have older children, please have them register as an Adult Participant (above).
Name*

First NameLast Name
Age *
Name

First NameLast Name
Age
Name

First NameLast Name
Age
Name

First NameLast Name
Age
Please tell us the name of the relative who died and their cause of death. *
Are all participating family members aware of the cause of death? *
How did you learn about this program? *
While we understand that schedules can change due to unforeseen circumstances, we ask that you consider your submission a commitment to the full term of the series. If you know you or your family members will miss more than one session, especially the closing session, please register for another date so we can offer this space to another grieving family on our wait list.*

We have reviewed dates/times and confirm our availability.
Signature*

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Family Grief Support Series

Children's Information: