Lakes Region Community Services Parent Ed Registration

Building Bridges, Families in Recovery, Parenting Journey in Recovery, & Parenting Journey 2 may be facilitated by staff from partner agencies including Archways Community Resource Center and/or Navigating Recovery of the Lakes Region. In order to complete the registration process, we will need to share the information on this form with those agencies. Do we have your permission? (If you select "No", you will be contacted by a member of our staff to discuss completion of your registration.)

Yes, you have my permission to share the information on this form with Archways and/or Navigating Recovery
No, you do NOT have my permission to share any information with Archways and/or Navigating Recovery

Parent / Caregiver
Professional

Name	Date of Birth