Kids' Turn

55 New Montgomery St., Suite 500, San Francisco, CA 94105

Phone: (415) 777-9977 Fax: (415) 777-1577

Web site: www.kidsturn.org

 

Payment MUST accompany registration to reserve space in the workshop

(Payment options: Mail or fax Fee Schedule with payment or pay by going to our donations page)

 

Parent Information:
Last name:   First name:   Ethnicity:

Address:    City:  ST:   Zip:

Home phone:    Alternate Phone:    Email: 

Work Shop choice    and start date (Example OAK 1/25/10): 

 

Other Parent information: (Does NOT mean he/she is registered)

Last name:   First name:   Email: 

Address:   City:  ST:   Zip:

Child(ren)?s Name(s):

First Last DOB Ethnicity Health/Allergies Counseling

 

How long were you with the other parent?   How long have you been apart?  

What percentage of child custody do you have?  %

Child Protective Service Report (CPS)?  

**Note: If there are any CPS reports you must provide Kids? Turn with a copy of the report.

 

Restraining Order? 

**Note: If you have any restraining orders (RO) or temporary restraining order (RTO), you must provide Kids? Turn with a copy of the court orders.

Domestic Violence (Yes or No):  

On a scale from 1-10 (10 being extremely conflicted), rate your co-parenting conflict:   

Tell us two things that makes your child special:      1.

                                                                                  2.

Notes or additional information you would like us to have:

 

    

 

Please Note:  Your registration is not complete until payment is received. See Fee Schedule .