LAKES REGION MENTAL HEALTH CENTER
Child Impact Program Online Registration Screen#1
Course Fee: 85.00
(Payment is by Credit Card or PayPal after clicking PayPal button on next page)
Please Note: there is a $10 fee for rescheduling or cancellation without 24 hrs notice!
CIP REGISTRATION PART #1
Name:
Spouse Name:
Enroll in a different class from spouse?
Yes
No
Is there a restraining order?
Yes
No
Please Note: this class is In-Person not Virtual!
CANCEL
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