Helping Parents Love
Group meetings begin May 7 (Tue) or May 9 (Thurs). You’ll receive a confirmation email upon completion of this form, then further information will be sent by your group leaders at a later date.
Name
*
First Name
Last Name
Spouse Name (if participating)
First Name
Last Name
Primary Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How does your child identify? (gay, trans, etc.)
Group Options (Select One)
*
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Group 1 (Markham/Sulya)
Meets on Tuesdays, 6–8pm Eastern. Begins May 7.
$
149.00
Group 2 (Johnson/Mulder)
Meets on Thursdays, 9-11pm Eastern. Begins on May 9.
$
149.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: