Family Grief Series Registration Form

Family Grief Support Series

Brighter Days Family Grief Center
We are pleased to welcome you to our Family Grief Support Series. This weekly program is designed for grieving youth (ages 5–17), young adults (ages 18–26), parents, grandparents, and extended family members. Please note that a parent or guardian must attend the adult sessions when registering youth under 18.

Our group leaders consist of experienced staff and trained volunteers skilled in facilitating supportive discussions and offering resources and healthy coping strategies for you and your family. They do not provide grief counseling. If you are interested in meeting with one of our master’s-level grief counselors, please contact us to explore counseling options.

Youth and young adults will participate in age-appropriate groups where they can share about their loved one. Adults will meet together in a single group to reflect on their loss while also receiving guidance on how to best support the grieving youth and young adults in their care.

For families attending a virtual series, each participant will need access to an electronic device such as a desktop computer, laptop, tablet or phone. To ensure privacy for all group members, participants must join from separate rooms within the home.

Brighter Days reserves the right to determine participant readiness before and during the program to ensure that each individual receives the appropriate level of support. In the event of inclement weather, all in-person sessions will be moved to a virtual format.
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 (Please note: children must be at least 5 years old to participate):*
Name

First NameLast Name
Age (Please note: children must be at least 5 years old to participate):
Name

First NameLast Name
Age (Please note: children must be at least 5 years old to participate):
Name

First NameLast Name
Age (Please note: children must be at least 5 years old to participate):
Please tell us the name of the relative who died and their cause of death. *
Please tell us their relationship to your children (parent/sibling/grandparent, etc.) *
Are all participating family members aware of the cause of death? *
How did you learn about this program? *
We understand that unexpected conflicts can arise, but we ask that you consider your submission a commitment to the full series. If you already know that you or a family member will need to miss more than one session, especially the last session, please register for a future date so we can offer this spot to another grieving family on our waitlist.*

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

Clear
One of our team members will connect with you within 5 business days of receiving your submission to share more about the series, answer any questions, and talk through readiness for you and your family.

Because a brief phone conversation is required before joining, we will only add families to the list once we have been able to talk with you. If we don’t hear back, we will provide your spot to another family and look forward to having you join us at another time.
Should be Empty:

Family Grief Support Series

Children's Information: