• Beautifully Flawed® 2026 "Roots & Wings" (Parent Support Group) Consent Form

  • Who We Are

    Founded in 2014 by girls, Beautifully Flawed (BF)® is an Ohio based 501(c)3 nonprofit that provides free mental health education, leadership development, and support resources to girls and families.

  • Beautifully Flawed® "Roots & Wings" (Parent Support Group)

    Beautifully Flawed® recognizes parents need mental health education and social support too. That's why we've teamed up with Meadows Counseling Group to provide a FREE 6-week series just for you!

    Workshops Dates

    All held virtually on Tuesdays from 6:00 PM-7:15 PM (A link to join the sessions will be sent to you once your registration has been submitted and approved).

    • Session 1: September 15th (Mental Health & Trauma 101)
    • Session 2: September 22nd (Self-Care & Coping As A Parent)
    • Session 3: September 29th (Identifying Personal Triggers & How They Show Up In Parenting)
    • Session 4: October 6th (Recovering After Conflict)
    • Session 5: October 13th (Parental Education & Guidance on Teen's Social Media Usage)
    • Session 6: October 20th (Building A Supportive Community with Other Parents & Families)

    Your participation in the Beautifully Flawed® "Roots & Wings" Parent Support Group is voluntary; therefore, you have the right to stop attending at any time; however, completion and participation within the workshops are necessary to experience the full benefits of the series. It is highly encouraged to attend all sessions. 

  • Unable to Attend A Session?

    If unable to attend a workshop, please communicate in adavance with Beautifully Flawed's® Founder and Executive Director:

    Charity Harrison, LPCC

    charity@bflawed.org

    (614) 500-3739

  • Disclaimer
    Beautifully Flawed® workshops hosted by the nonprofit or its partnered affiliates does not provide direct individual or group therapy for the services rendered on this consent form. However, programming sessions are facilitated by Licensed Clinicians and Certified Wellness Instructors who may belong to agencies that provide direct individual or group therapy. The Beautifully Flawed® parent support group does not substitute the need for individual therapy or crisis resources.

    For high-risk identified adults, Beautifully Flawed® will refer the person to counseling resources and/or intensive inpatient or outpatient crisis care for continued support.

     

    For all crisis concerns, please utilize crisis support: 

    **The numbers are answered 24 hours a day, 7 days a week.*

    National Crisis/Suicide Prevention Lifeline- 988

    Nearest Psychiatric Hospital

    Franklin County Crisis Center

    Emergency Services- 911 (Can request for a mental health team to arrive)

    National Maternal Mental Health Hotline- 833-TLC-MAMA 

  • Cost of Parent Support Group
    The cost of the 6-week "Roots & Wings" parent support group is free to parents. The 6-week services are 100% covered by Beautifully Flawed® sponsors, grant partners, and individual donors.


    While no financial commitment for the 6 support sessions are required from you, we ask for respect of the investment by others for your betterment by committing to attending all sessions, participating, and becoming an ambassador for Beautifully Flawed® and mental health.   

  • Registrant's Information

  • Are you a resident of Franklin County (OH)?*
  • Format: (000) 000-0000.
  • Date of Birth *
     - -
    2 digit month, 2 digit day, 4 digit year
  • Age*
  • Race/Ethnicity: Select all that apply*
  • Sex*
  • Income Level: What is your approximate total annual household income before taxes? Please include income from all members of your household. This information is collected for demographic and grant purposes only.*
  • How many people currently live in your household, including yourself?*
  • Are you a parent or legal guardian of elementary-high school child?*
  • Do you have any diagnosed intellectual, sensory, physical, and/or mental health challenges or disabilities that would need accommodated for? This helps us provide appropriate supportive care- but is not required to answer.*
  • If we reach capacity (10 parents), would you like to be contacted about the next group offering?*

  • Emergency Contact Information

  • Emergency Contact's Relationship to the Registrant*
  • Format: (000) 000-0000.

  • Beautifully Flawed® "Roots & Wings" Parent Support Group Consent

    I am at least 18 years of age and am competent to contract my own name.

    I will participate in the Beautifully Flawed® Parent Support Group (September 2026- October 2026). I have read this release before signing below and I fully understand the content, meaning, and impact of the program.  

  • Beautifully Flawed® Photo/Video Release Consent

    For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby grant Beautifully Flawed® and its affiliated partners permission to use my likeness in a photograph and/or video in any and all of its publications, including but not limited to all of Beautifully Flawed’s® printed and digital publications. I understand and agree that any photograph using my likeness will become property of Beautifully Flawed® and its affiliated partners.

    I hereby irrevocably authorize Beautifully Flawed® to edit, alter, copy, exhibit, publish, or distribute this photo for purposes of publicizing Beautifully Flawed’s® and its affiliated partners' programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears, unless provided by Beautifully Flawed® and its affiliated partners the option to do so. Additionally, I waive any right to royalties or other compensation arising out of, or related to, the use of the photograph and video production.

    I hereby hold harmless and release and forever discharge Beautifully Flawed® and its affiliated partners from all claims, demands, and causes of action which I, my heirs, representatives, or executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

    Compensation

    I acknowledge that since my participation with Beautifully Flawed® and its affiliated partners in its entirety including but not limited to: photography, videography, attending workshops, etc. is voluntary- I will receive no financial compensation.

    By Signing this form, I acknowledge that I have read this form its entirety and completely understand all the undertaking.

  • Should be Empty: