CLIMB® Training Registration Page

Payment can be combined if more than one person is attending from your organization. You can pay online or by check. Payment options are provided when you submit your registration.

Attendee (required):

Select Workshop June 1-3, 2018 Atlanta, GA (immediately following the AOSW Conference)October 2018, Denver, CO dates TBD

Address(required):

Employer:

Work Phone:

Cell Phone:

Your Email (required)

Position Title

Area of Expertise

If answered other, please state area of expertise:

Day Arriving (MM-DD-YYYY):

Day Departing (MM-DD-YYYY):

I acknowledge by checking this box and typing my name below that I understand that CLIMB® is a mental health promotion program. I agree to always operate the CLIMB® program under the direction of trained professionals with education and training in group facilitation, oncology, and child development.