Wise Up Form Example

W.I.S.E. Up!® April 2026

Primary Parent Name(Required)

First Last

This parent will be in attendance

Secondary Parent Name

First Last

This parent will be in attendance

Child's Name(Required)

First Last

If you have more than one child to register, please complete a new registration form for each child.

Child's Date of Birth(Required)

Is your child in 3rd or 4th grade?(Required)

Yes

Was your child's adoption through The Cradle?(Required)

Yes

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is there anything you would like the facilitators to know about your child or the adoption process beforehand?

OPTIONAL: Research Opportunity

Emily Helder, Ph.D., Professor of Psychology at Hope College, is working in partnership with CASE to evaluate the impact of W.I.S.E. Up! for youth and families. Workshop participants have the option to join her study. Participation would involve children and their parents completing a brief online questionnaire before and after the workshop, receiving a monthly email with a W.I.S.E. Up! discussion prompt that can be used at home during the 6 months after the workshop, and repeating the initial questionnaire at the end of those 6 months. The results from families participating in this project across multiple sites will be combined to better understand the impact of W.I.S.E. Up! and further support adopted and fostered youth and their families with effective programming. For further details and to ask questions, contact Dr. Helder (helder@hope.edu).

I consent to participating in this research opportunity (optional)

OPTIONAL: Consent to Share Contact Information

I would like my contact information included in a shared list for participating families who wish to stay connected following the session (optional)

W.I.S.E. Up! Workshop(Required)

Price:

Only purchase a registration slot for your child. Parents are included. If you need to register more than one child, please complete a new registration form for them.

Total

Credit Card

I'm Pregnant

Adoption Services

Counseling, Education & Training

I'm Pregnant

Adoption Services

Counseling, Education & Training

Wise Up Form Example

W.I.S.E. Up!® April 2026

Unplanned Pregnancy?

Adoptive Families & General Inquiries

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