Support Group Reg Form | CopingAfterSuicide

Support Group Registration form

When he/she/they died, they were:

When he/she/they died, I was:

Are you 18 or older? (required)*

Yes, I am 18 or older

I am under 18 (OR registering for someone who is under 18).

I accept the terms and conditions, and I understand that the non-refundable registration fee cannot be prorated or partially refunded*

Your Signature (Parents/Guardians don't sign here - see below)

As parent/guardian, I have spoken with Steve Karaiskos

As parent/guardian, I accept the terms and conditions, and I understand that the non-refundable registration fee cannot be prorated or partially refunded*

Parent/Guardian Signature

Non-refundable registration fee payable in full. (choose one)

New Member - $435

Continuing/Returning Member - $395

Registration fee paid by another entity. Adminstrative fee only - $50

Thank you for registering. You'll be receiving a confirmation email with the Zoom link and additional information soon.

The email will be coming from copingaftersuicide.assistant@gmail.com.

If you haven't received an email within 3 days, please check your junk/spam folder.

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