FOR SOMEONE

  

                  SPECIAL

 

Dear Kids,

Suppose……someone told you that you are special?  Yet, sometimes you feel sad because your family changed…

or you are angry because you have so many chores….

or feel out of place when you see friends with a mom and dad together….

or you feel you must keep your parent happy, especially when they are sad….

or there is some other painful loss in your family. 

There is finally a time set aside just for you to get together with other kids your age to talk about what is happening in your life.

Complete the registration form below if you would like to be a part of this special group for all children just like you.  You can print this form and then fill it out and bring to the school office.

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Rainbow Program

  

 

Child’s Name ___________________________________  Age ______  Grade ________

 

Address ________________________________________________________________

 

City ________________________  Zip ____________  Phone # ___________________

 

Signature: (Child) _________________________________________________________

 

Signature: (Parent) ________________________________________________________

 

 Please check:           _____ My parents are divorced.            _____ My parent has died.

 

My loss is _______________________________________________________________            (please explain)

 

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