Hope@Home™ Groups Registration

Our mission is to inspire hope in young families, with children 18 or under, facing the loss of a parent to a life-threatening illness.

Who is this registration for? Required*

Comments

Which group(s) are you interested in?
(click here for options/descriptions) Required*

Caregiver Coffee Hour

Friday Morning Gatherings

Just Show Up Book Club

Living with Illness

Public Reading of Scripture

Member's Information:

First Name* Required*

Last Name* Required*

Birthdate* Required*

Mobile* Required*

E-Mail* Required*

Street Address* Required*

City* Required*

State* Required*

Zip* Required*

If your primary household language is not English,
please type it here: Required*

How many children in the household:* Required*

Family religious/spiritual affiliation (Optional) Required*

How did you hear about Inheritance of Hope?* Required*

Have you/your family utilized/participated in any other services with Inheritance of Hope?
If so, which ones?
(Check all that apply) Required*

Legacy Retreat®

Hope@Home™ Weekend

Annual Legacy Event

Hope@Home™ Group

Hope@Home™ App

Which applies to your family? *
Please provide the information. *

I or someone in my family have been diagnosed with a life-threatening illness.

-Diagnosis:

-Date of diagnosis:

Self or family member?:

My family has already experienced the loss of a loved one.

-Loved one's relationship to you:

-Date of Death:

I am supporting others in their grief/loss.

Tell Us About Your Family:

Most Hope@Home™ Groups meet three weeks of every month for one hour via Zoom. The goal of Hope@Home™ Groups is to provide a hope-filled community of care with people who “get” it. sense of community, belonging, and connection for young families experiencing the illness or loss of a parent.

What is one word (or a phrase) that would describe how you/your family are currently coping with grief?*
Required*

What do you hope to gain by attending a Hope@Home™ Group?*
Required*

Any other information that would be helpful for our group facilitators to know about how we can best come alongside you? (optional) Required*

Acknowledgement:

Support Group Agreement*

I understand the purpose of Hope@Home Groups™ is to encourage a confidential and safe place for connection and shared experiences. The purpose of groups is not to provide counseling or therapy, but rather offer support through resources and relationships.

I agree*

Required*

Recording Agreement*

By registering for this group, I give permission to Inheritance of Hope to photograph, film, and/or record and use those materials to encourage more people to enjoy this valuable resource.

I agree*

Required*

Hope@Home Direct Contact Agreement

Inheritance of Hope trained volunteers may contact me directly to offer encouragement and on-going support outside of group meetings.

I agree

Required*

SMS Opt-In* You must agree to the term*

By providing your/your family's phone number(s), you agree to receive text messages from Inheritance of Hope.
Message & data rates may apply. Message frequency varies.
Reply STOP to opt out, reply HELP for help

Opt-in*

Comments

Which group(s) are you interested in?
(click here for options/descriptions) Required*

Friday Morning Gatherings

Just Show Up Book Club

Life After Loss

Public Reading of Scripture

Member's Information:

First Name* Required*

Last Name* Required*

Birthdate* Required*

Mobile* Required*

E-Mail* Required*

Street Address* Required*

City* Required*

State* Required*

Zip* Required*

If your primary household language is not English,
please type it here: Required*

How many children in the household:* Required*

Family religious/spiritual affiliation (Optional) Required*

How did you hear about Inheritance of Hope?* Required*

Have you/your family utilized/participated in any other services with Inheritance of Hope?
If so, which ones?
(Check all that apply) Required*

Legacy Retreat®

Hope@Home™ Weekend

Annual Legacy Event

Hope@Home™ Group

Hope@Home™ App

Which applies to your family? *
Please provide the information. *

I or someone in my family have been diagnosed with a life-threatening illness.

-Diagnosis:

-Date of diagnosis:

Self or family member?:

My family has already experienced the loss of a loved one.

-Loved one's relationship to you:

-Date of Death:

I am supporting others in their grief/loss.

Tell Us About Your Family:

What is one word (or a phrase) that would describe how you/your family are currently coping with grief?*
Required*

What do you hope to gain by attending a Hope@Home™ Group?*
Required*

Any other information that would be helpful for our group facilitators to know about how we can best come alongside you? (optional) Required*

Acknowledgement:

Support Group Agreement*

I agree*

Required*

Recording Agreement*

By registering for this group, I give permission to Inheritance of Hope to photograph, film, and/or record and use those materials to encourage more people to enjoy this valuable resource.

I agree*

Required*

Hope@Home Direct Contact Agreement

Inheritance of Hope trained volunteers may contact me directly to offer encouragement and on-going support outside of group meetings.

I agree

Required*

SMS Opt-In* You must agree to the term*

Opt-in*

Comments

Which group(s) are you interested in?
(click here for options/descriptions) Required*

Kids' Group (7-12)

Kids Life After Loss

Teen Group (13-18)

Primary Parent/Guardian's Information:

First Name* Required*

Last Name* Required*

Birthdate* Required*

Mobile* Required*

E-Mail* Required*

Street Address* Required*

City* Required*

State* Required*

Zip* Required*

If your primary household language is not English,
please type it here: Required*

Family religious/spiritual affiliation (Optional) Required*

How did you hear about Inheritance of Hope?* Required*

Have you/your family utilized/participated in any other services with Inheritance of Hope?
If so, which ones?
(Check all that apply) Required*

Legacy Retreat®

Hope@Home™ Weekend

Annual Legacy Event

Hope@Home™ Group

Hope@Home™ App

Which applies to your family? *
Required*

I or someone in my family have been diagnosed with a life-threatening illness.

-Diagnosis:

-Date of diagnosis:

Self or family member?:

My family has already experienced the loss of a loved one.

-Loved one's relationship to you:

-Date of Death:

I am supporting others in their grief/loss.

Names of Youth/Child
Registering for Group:

First Name* Required*

Last Name* Required*

Birthdate* Required*

Relationship to applicant:* Required*

Please tell us a little bit about this child’s personality, interests, and hobbies. * Required*

Comments (any special needs, difficulty coping, etc.)

If you have more than 6 children, please enter their info below.

Tell Us About Your Family:

What is one word (or a phrase) that would describe how you/your family are currently coping with grief?*
Required*

What do you hope to gain by attending a Hope@Home™ Group?*
Required*

Any other information that would be helpful for our group facilitators to know about how we can best come alongside you? (optional) Required*

Acknowledgement:

Support Group Agreement*

I agree*

Required*

Recording Agreement*

By registering for this group, I give permission to Inheritance of Hope to photograph, film, and/or record and use those materials to encourage more people to enjoy this valuable resource.

I agree*

Required*

Hope@Home Direct Contact Agreement

Inheritance of Hope trained volunteers may contact me directly to offer encouragement and on-going support outside of group meetings.

I agree

Required*

SMS Opt-In* You must agree to the term*

Opt-in*

Comments

Which group(s) are you interested in?
(click here for options/descriptions) Required*

Friday Morning Gatherings

Just Show Up Book Club

Public Reading of Scripture

Member's Information:

First Name* Required*

Last Name* Required*

Birthdate* Required*

Mobile* Required*

E-Mail* Required*

Street Address* Required*

City* Required*

State* Required*

Zip* Required*

If your primary household language is not English,
please type it here: Required*

How many children in the household:* Required*

Family religious/spiritual affiliation (Optional) Required*

How did you hear about Inheritance of Hope?* Required*

Have you/your family utilized/participated in any other services with Inheritance of Hope?
If so, which ones?
(Check all that apply) Required*

Legacy Retreat®

Hope@Home™ Weekend

Annual Legacy Event

Hope@Home™ Group

Hope@Home™ App

Which applies to your family? *
Please provide the information. *

I or someone in my family have been diagnosed with a life-threatening illness.

-Diagnosis:

-Date of diagnosis:

Self or family member?:

My family has already experienced the loss of a loved one.

-Loved one's relationship to you:

-Date of Death:

I am supporting others in their grief/loss.

Tell Us About Your Family:

What is one word (or a phrase) that would describe how you/your family are currently coping with grief?*
Required*

What do you hope to gain by attending a Hope@Home™ Group?*
Required*

Any other information that would be helpful for our group facilitators to know about how we can best come alongside you? (optional) Required*

Acknowledgement:

Support Group Agreement*

I agree*

Required*

Recording Agreement*

By registering for this group, I give permission to Inheritance of Hope to photograph, film, and/or record and use those materials to encourage more people to enjoy this valuable resource.

I agree*

Required*

Hope@Home Direct Contact Agreement

Inheritance of Hope trained volunteers may contact me directly to offer encouragement and on-going support outside of group meetings.

I agree

Required*

SMS Opt-In* You must agree to the term*

By providing your phone number, you agree to receive text messages from Inheritance of Hope.
Message & data rates may apply. Message frequency varies.
Reply STOP to opt out, reply HELP for help

Opt-in*

If you have any technical issues with this form,
please email Tech@InheritanceOfHope.Org

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