Family Friday

Family Friday Registration

Friday, November 15, 2024

5:30 - 7:00 pm

Location: Plymouth First United Methodist Church, 45201 N. Territorial Road, Plymouth, MI 48170

Part of our Circles of Hope program which provides a family-centered approach to grief support by investing in children, supporting parents, and strengthening the family. Throughout the year, we offer this monthly family-based program. Dinner is provided, along with break-out sessions, discussions, and activities to provide tools to help navigate the grief journey. We offer a unique theme, and activity each month. This month’s theme is "Art Studio". Ages: 4-14

Due to the generosity of grantors, donors, and sponsors, New Hope is able to provide our programming resources to participants at no cost. To help us steward our resources, please note, if you have registered, but are no longer able to attend, please contact our office by noon the day prior of the program or event.

You can contact us at 248-348-0115 or email us at [email protected].

* Required Fields

Parent/Caregiver Contact Information

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Main Phone

Birthdate

Relationship of loss to yourself (e.g. spouse, child, parent, etc.)

Are you registering as a DHD (Detroit Health Department) referral?

YesNo

* Are you registering as a DHD (Detroit Health Department) referral? is required.

Child Participant Information- Please complete for each child attending Family Friday

Name of Child 1 (Include First and Last)

Date of birth for Child 1

Name of Child 2 (Include First and Last)

Date of birth for Child 2

Name of Child 3 (Include First and Last)

Date of birth for Child 3

Name of Child 4 (Include First and Last)

Date of birth for Child 4

Name of Child 5 (Include First and Last)

Date of birth for Child 5

Relationship of Loss to Child

Date of the loss

Has everyone listed attended a Circles of Hope or New Hope program before?

YesNo

* Has everyone listed attended a Circles of Hope or New Hope program before? is required.

Additional Information about your child's loss

Submit

I have voluntarily provided the above information which is true and correct to the best of my knowledge.

I understand that:
a). the services provided by the staff and volunteers of New Hope Center for Grief Support are strictly support services and not professional counseling; b). as a part of that support, New Hope may provide follow-up communication via phone and/or email.

Photo Release
I agree to allow New Hope Center for Grief Support to use my and/or my child(ren) photographs and video footage on their website and other promotional documents from this event as they see fit.

Hold Harmless
I agree to hold harmless the host location of this event, New Hope Center for Grief Support, their employees, volunteers, officers, and directors from any claim or action that may arise from my own or my child(ren) participation in the event or involvement in any capacity.

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount filed. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave for automatic processing of your future payments. Notify us at any time if you wish to discontinue your pledge.