SOCIAL SKILLS GROUP INTEREST FORM

Fall 2024 Social Skills Group Interest Form

Basic Information

MM slash DD slash YYYY
Has your child received services at SRC or The Southfield Center previously?(Required)
Was your child in a previous group? Select one facilitator:
Please select the group you are interest in:(Required)
NOTE: No Session Halloween (10/31) or Thanksgiving (11/28)
Select which of these activities your child enjoys or would benefit from:(Required)

If your child is new to Sasco River Center, please email Christi (czacarola@sascoriver.com) with the subject line "New Group Member Registration." In the body of the email, include the following:
  • Child's name
  • Child's Date of Birth
  • Mailing address
  • Caregiver(s) full names
  • Best phone number and email
Please note that new clients will need to complete a virtual, 45-minute intake with a staff member. Christi can assist in scheduling this appointment.
This field is for validation purposes and should be left unchanged.