Children's Grief Support Groups: Registration Form

Lionheart is pleased to be offering Children’s Grief Support Groups in Term 2 for children aged 7–12 years who have experienced the death of someone important in their life and have previously attended a New Families Camp.

These small, supportive groups will run over a period 6 weeks, with 3 fortnightly sessions on the following dates:

Sunday 10th May

Sunday 24th May

Sunday 7th June

Groups will run from 2pm to 4:30pm. The first two sessions will be held at the Lionheart Office (4b2 Mulgul Road, Malaga) and the final celebration session will be held at Bounce in Osborne Park.

Our support groups will create a space where children can feel safe, understood, and feel less alone in their grief.

Throughout the first two sessions, children will be invited to take part in guided conversations, creative activities, and practical tools to help them make sense of their feelings and find ways to express them. The final session will be a special celebration, acknowledging each child’s journey, the connections they have made, and the courage they have shown along the way -at our super fun location of Bounce!

This pilot program is proudly funded by the Stan Perron Charitable Foundation and delivered in partnership with Siblings Australia, allowing us to offer the program free of charge to families.

To help each child feel comfortable, heard, and supported, groups will be kept small and places will be limited. Parents and carers are not required to stay during the sessions; you can drop your child and have some time to yourself or we will circulate places nearby where parents can meet for a cuppa and chat together.

We are currently accepting registrations. If you feel this group may be a helpful support for your child, we warmly invite you to complete the form below. Places are limited so please submit your registrations early.

Parent/Caregiver Name*

First NameLast Name

Phone Number*

Mobile

Email*

example@example.com

PhoneEmail

Additional Emergency Contact Name (not yourself)*

First NameLast Name

Phone Number*

Mobile

Relationship to child*

Child 1 Name*

Child 1 Date of Birth*

Date

Do you have any current concerns for your child you feel is important for Lionheart to be aware of? Anything you share will help us to provide the best support and information we can during our program.*

Does your child have any allergies, medical conditions or dietary requirements we should be aware of? If yes, please detail below:

If yes, please upload a copy of their current medical/allergy/asthma action plan

Child 2 Name

Child 2 Date of Birth

Date

Do you have any current concerns for your child you feel is important for Lionheart to be aware of? Anything you share will help us to provide the best support and information we can during our program.

Does your child have any allergies, medical conditions or dietary requirements we should be aware of? If yes, please detail below:

If yes, please upload a copy of their current medical/allergy/asthma action plan

I agree to my child(ren) being involved in Lionheart Camp for Kids' Children's Support Group program.My information will be stored securelythe Lionheart team is committed to maintaining my confidentiality and privacyLionheart facilitators and volunteers do have a limit to their confidentiality and if concerns are held for the safety and/or well-being of myself or my child(ren), confidentiality will be broken in order to seek assistance and support from appropriate professionals as required.

YES. According to the consent for photography form below, I DO give consent for myself and/or my children to be photographed and videoed during Lionheart activities. I understand that Lionheart may use these photographs and videos in any publications, brochures, films or websites produced by Lionheart Camp for Kids.NO. According to the consent for photography form below, I DO NOT give consent for myself and/or my children to be photographed or filmed during Lionheart activities.

Thank you for registering for Lionheart's Children's Grief Support Group.

After reviewing registrations, we will be in touch to confirm your child's place in the Term 2 group. If we are unable to offer a spot in our first group, we may offer a place in our group during Term 3.

CHILDREN'S SUPPORT GROUP

Caregiver/Parent Details

Emergency Contact Details

Participant Details

Consent

Submission