Child Details
 
Terms and Conditions: This live session is being recorded and may be posted or re-shared online. If you decide to leave your video on and list the name of your child/teen, it will be part of the recording and will be considered that you have given permission for CAGIS' use. If you do not want your child's/teen's image or name to be part of the video, please ensure that the camera settings are turned off (listed at the bottom of the screen), and enter a pseudonym rather than your child's/teen's name. If your child/teen would like to ask a question and you do not want her voice to be part of the session, she may ask the question in the chat window.
Total Fee(s)
Credit Card
*
*
*
 
Billing Name and Address
*
*
*
*
*
*
*
Family Information
Parent/Guardian 1
Parent/Guardian 2