Parent Registration Form Page 2
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1
2What percentage of child custody do you have? __________%
Your Ethnicity optional)
Other: Please enter
I will be requesting a fee reduction for the tuition costs.
Yes
Are you currently serving in the military?
Yes
Have you ever served in the military?
Yes
Is a restraining order in effect?
Yes
If yes*** you must provide Kids’ Turn with a copy of the court orders).
Please describe the details of the restraining order
_____________________________________________________________________
On a scale of 1 - 10 (with 10 being extremely conflicted), rate your co-parenting conflict.
Please
one:
1
Are there any specific safety concerns you have about yourself or your children during your
family’s participation in the Kids’ Turn program?
If yes, please explain: ___________________________________________________
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