Healthy Relationships
How to have long-lasting healthy romantic/sexual relationships
40 Dean St. Unit A
Thursdays 4:30-6:00 PM Starting June 11th through August 6th
Name of Participant
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Participants Email
example@example.com
Participants Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Guardian/Parent
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DDS Eligibility
ASD
ASD/ID
Not DDS Eligible
Unsure
This course requires a level of maturity. We will be discussing mature topics and describing mature acts. If a participant is not taking this material seriously, Community Autism Resources reserves the right to remove them from the course.
*
I understand
This is a safe space; we are welcoming of all gender identities, sexual orientations, and abilities. We strive to respect everyone where they are. If a participant can't be respectful of others' lifestyles, they will be asked to leave.
*
I understand
Can Community Autism Resources use your photograph for marketing purposes on our website, Facebook, Instagram, and flyers promoting the Healthy Relationships course?
Yes, I give CAR permission to use my photo
No, I do not give CAR permission to use my photo
Are there any dietary restrictions for young adult and/or social coach (we will be serving snacks and drinks)
If you have any questions or concerns please reach out to Sarah at SWalkden@communityautism.org
Registration is limited. Payment wont be required until you recieve a confirmation email
The cost of this class is $200 for anyone 22 and older. If you have questions about payment options, please reach out to Swalkden@communityautism.org
I understand
Submit
Should be Empty: