• 2026 Grieving Families Healing Together Application

  • Please complete this application for your family to participate in the Wendt Center for Loss and Healing's Grieving Families Healing Together workshop series. All workshops are in person at our office at 4201 Connecticut Ave NW Suite #300, Washington, DC.

    All activities are specifically designed to help families acknowledge their grief together, express themselves, honor loved ones who have died, and learn new ways of coping. The Wendt Center strives for an environment that cultivates kindness, compassion, respect, and inclusivity, in an intentional and affirming way. 

    Workshops have limited capacity - please ensure at least one adult and one child from your family will be able to participate in workshop(s) selected. Workshops are appropriate for children ages 5-17 and their adult family members. Once you submit your application, you'll receive an email with information about the workshops you selected. We will reach out to let you know whether your family is confirmed for each workshop or your family has been placed on the waitlist. 

    This form should be filled out by an adult and should only include children in your family that you have legal authority to sign forms for.


    All workshops are FREE!! 

  • Application Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Caregiver Date of Birth*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • What is the Caregiver's race/ethnicity? (Select all that apply)*
  • What is the Caregiver's gender?*
  • What are the Caregiver's pronouns?*

  • Adult Participant(s)

  • First Additional Adult

  • Adult's Date of birth (if known)
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the adult's race/ethnicity? (Select all that apply)*
  • What is the adult's gender?*
  • What are the adult's pronouns?*
  • This person is the caregiver's ____________________________.*

  • Second Additional Adult

  • Date of birth (if known)
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the adult's race/ethnicity? (Select all that apply)*
  • What is the adult's gender?*
  • What are the adult's pronouns?*
  • This person is the caregiver's ____________________________.*

  • Third Additional Adult

  • Date of birth (if known)
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the adult's race/ethnicity? (Select all that apply)*
  • What is the adult's gender?*
  • What are the adult's pronouns?*
  • This person is the caregiver's ____________________________.*

  • Fourth Additional Adult

  • Date of birth (if known)
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the adult's race/ethnicity? (Select all that apply)*
  • What is the adult's gender?*
  • What are the adult's pronouns?*
  • This person is the caregiver's ____________________________.*

  • Child Participant(s)

  • First Child

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the child's race/ethnicity? (Select all that apply)*
  • What is the child's gender?*
  • What are the child's pronouns?*
  • The caregiver is this child's ___________________________.*

  • Second Child

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the child's race/ethnicity? (Select all that apply)*
  • What is the child's gender?*
  • What are the child's pronouns?*
  • The caregiver is this child's ___________________________.*

  • Third Child

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the child's race/ethnicity? (Select all that apply)*
  • What is the child's gender?*
  • What are the child's pronouns?*
  • The caregiver is this child's ___________________________.*

  • Fourth Child

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the child's race/ethnicity? (Select all that apply)*
  • What is the child's gender?*
  • What are the child's pronouns?*
  • The caregiver is this child's ___________________________.*

  • Fifth Child

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • What is the child's race/ethnicity? (Select all that apply)*
  • What is the child's gender?*
  • What are the child's pronouns?*
  • The caregiver is this child's ___________________________.*

  • Deceased Individual(s)

  • First Individual

  • What was this person's cause of death?*
  • Was this person considered a primary caregiver to any of the children?*

  • {Deceased1Name} was {caregiverName}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Adult1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Adult2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Adult3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Adult4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Child1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Child2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Child3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Child4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased1Name} was {Child5name}'s ______________.

  • Select a response to fill in the blank above.*

  • Second Individual

  • What was this person's cause of death?*
  • Was this person considered a primary caregiver to any of the children?*

  • {Deceased2Name} was {caregiverName}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Adult1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Adult2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Adult3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Adult4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Child1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Child2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Child3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Child4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased2Name} was {Child5name}'s ______________.

  • Select a response to fill in the blank above.*

  • Third Individual

  • What was this person's cause of death?*
  • Was this person considered a primary caregiver to any of the children?*

  • {Deceased3Name} was {caregiverName}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Adult1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Adult2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Adult3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Adult4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Child1name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Child2name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Child3name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Child4name}'s ______________.

  • Select a response to fill in the blank above.*

  • {Deceased3Name} was {Child5name}'s ______________.

  • Select a response to fill in the blank above.*
  • Have you or anyone else in your family received services from the Wendt Center for Loss and Healing in the past year?*
  • Please make a selection below:*
  • Is a member of your family in the US Military?*
  • What branch(es)?*
  • What is/are their current status(es)?*
  • In the last year, did you or anyone in your family qualify for any government assistance programs? (ie: WIC, SNAP, Housing, free/reduced lunch, Medicaid)*
  • Has any member of your family been exposed to the following types of violence? Select all that apply.*

  • Workshop Selection

  • Please review the list of workshops below, and select the ones you would like to attend. All workshops will take place at the Wendt Center Office near the Van Ness Metro Station on the Red Line.

    Note that at least one adult and one child must be in attendance at every workshop.

  • Threads of Memory: Creating, Connecting, and Giving Meaning in Times of Grief

    Saturday October 10th, 2026 from 10:00am to 12:00pm

    Facilitated by Luisa Mariño (Art Therapist), this will be a trauma-informed visual arts workshop where families explore grief and loss through drawing, painting, collage, and other creative forms.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • A Global Approach to Yoga with Grieving Families

    Saturday October 24th, 2026 from 10:00am to 12:00pm

    Facilitated by Johneé Wilson (Certified Yoga Instructor and Founder of Million Mats DC), this workshop will use Yoga and movement to connect with your body and spirit during times of grief.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • Healing Through Rhythm: A Drum Circle for Grieving Families

    Saturday November 7th, 2026 from 3:00pm to 5:00pm

    Facilitated by Batalá Washington, this workshop will use drumming and percussion from various world traditions to foster self-expression, inter-connection, and community healing.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • The Natural Imprint of Grief

    Saturday November 14th, 2026 from 10:00am to 12:00pm

    Facilitated by Tara Hoit (Certified Children's Grief Counselor, Certified Horticultural Therapist, and Virginia Master Gardener), during this workshop participants will connect with emotions associated with grief and loss through therapeutic connections with nature.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • Therapeutic Theater and Storytelling with Grieving Families

    Saturday December 5th, 2026 from 10:00am to 12:00pm

    Facilitated by Kristen Pilgrim (Drama Therapist) and Matt Reckeweg (Teaching Artist and Local Director), during this workshop the participants will practice expressing emotions related to grief through theater-based activities that focus on embodiment through vocalization, physicalizing experiences, and collaboration.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • When Words Aren't Enough: Movement While Grieving

    Saturday December 19th, 2026 from 10:00am to 12:00pm

    Facilitated by Ladonna Matchett (Dance Movement Therapist), this workshop will be a gentle exploration of movement and touch to support grief processing, emotional release, and communal connections.

  • Please select:*

  • Value should be between 2 and {maxParticipants}.

  • Parent/Guardian Permission Statement

  • I certify that I have legal authority to consent on behalf of the above named child(ren). The child(ren) described herein have my permission to engage in all selected workshops.

  • Liability Release

  • I understand and agree that Wendt Center for Loss and Healing, its Board of Directors, Employees, and Volunteers are released from any legal responsibility and/or liability arising out of my child(ren) and family's participation in the "Grieving Families Healing Together" Workshops.

  • Publicity Release

  • Recording and/or photography may occur during "Grieving Families Healing Together" Workshop activities. I understand that such material may be used in future publicity, fundraising, development purposes and/or educational efforts by the Wendt Center for Loss and Healing. 

  • Please select:*

  • Art Release

  • I give my consent that all art (visual, written, and performance) produced during the Wendt Center for Loss and Healing "Grieving Families Healing Together" Workshops can be used and/or photographed for documentation of therapeutic art programs, education of graduate student interns; research, presentations, and/or publication; exhibit or display; as well as fundraising or development purposes. I understand that my family's confidentiality will be protected at all times and that my family's name and other identifying data will be altered to preserve our identity.

  • Please select:*
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