Sibling/Parent Intake Form - SOAR
Please complete the below interest form for the Harrigan Development Services Siblings and Parent Group.  The group will meet six Mondays from 6:00-7:30PM starting June 3rd, 2024 thru July 8th, 2024.  Please contact Paul Grady at pgrady@harrigandevelopment.com with any questions.
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Email *
Which portion of the group are you interested in? *
Parent(s)' Name: *
Child's Name: *
Child's Date of Birth *
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DD
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Child's Grade for 24-25 school year: *
Address *
Phone Number: *
Please indicate funding source *
If applicable, please provide case manager/service facilitator/IRIS consultant contact information (ie Name, email, & phone number)
Tell us a bit about your child and their sibling including age.  If multiple siblings, please add information about the 2nd sibling below. *
What do you hope your child will gain from the sibling group?  Are there any particular topics you would like to see addressed? *
Are their any special needs, food allergies or other health restrictions of the sibling that we should know about for the group? *
I hereby give my child permission to participate in the siblings group.  I also agree to hold Harrigan Development Services harmless for any and all liability incurred as a result of my child's participation.

**This does not mean your child is automatically enrolled - For future use**
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