Virtual Teen Identity Group Registration Spring 2021

Interested in joining the WAITLIST for this sold out FREE event? Call 866.217.8534 to have your teen added to the waitlist. For teen adoptees in Northern Virginia! Register your teen for this FREE 6-week virtual support group, moderated by C.A.S.E. clinicians.

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PARENT OR GUARDIAN: First and Last Name*

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PARENT OR GUARDIAN: Email Address*

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PARENT OR GUARDIAN: Mobile Phone Number*

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PARENT OR GUARDIAN: Street Address*

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PARENT OR GUARDIAN: City*

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PARENT OR GUARDIAN: State*

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PARENT OR GUARDIAN: Zip Code*

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TEEN: First and Last Name*

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TEEN: Age*

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Teens in grades 7th - 9th are invited to attend

TEEN: Grade Level*

This field is required.

Teens in grades 7th -9th are invited to attend

How did you hear about this virtual teen identity group?*

C.A.S.E. Email / Enewsletter

Social Media

My C.A.S.E. Therapist

Adoption Agency

Friend or Colleague

Other

Please select all that apply.

I give consent for my child to participate in this virtual Teen Adoptee Identity Group with C.A.S.E. I understand that this group is clinical in nature.*

MUST check this box before proceeding with registration.

My child will be participating in the group over telehealth and the Zoom platform. Information shared in the group will remain confidential unless there is indication of harm to self or others.*

MUST check this box before proceeding with registration.

I understand that teens are expected to join each session from a private, secure location. I acknowledge that it is forbidden to record the group session.*

MUST check this box before proceeding with registration.

Interested in joining the WAITLIST for this sold out FREE event? Call 866.217.8534 to have your teen added to the waitlist.

WHEN
This is a 6-week group
Tuesdays, 4:30pm - 6:00pm EST

3/2/21
3/9/21
3/16/21
3/23/21
3/30/21
4/6/21

WHO
Teens in grades 7th-9th who have been adopted and who reside in Northern Virginia are invited to participate. This group will be capped at 10 participants.

WHERE
This new virtual group for teen adoptees will meet online using the secure, interactive Zoom Platform where each registered teen will be able to interact and see each other. All that's needed is a web cam, access to the internet and a quiet space. Once registered, the parent will receive a confirmation email with a link to access the virtual group and easy instructions for joining. The same link will be used to enter the group each week.

COST
FREE thanks to the Northern Post Adoption Consortium

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Virtual Teen Identity Group Registration Spring 2021