Help us help you and your children through the grief journey after the death of a loved one. Name * First Name Last Name Email * Phone (###) ### #### Relationship to child/children Do you have a child/children who has experienced the death of a loved one? yes no If yes, please tell us the age of the child and grade level. Tell us about the relationship of the loss to your child/children (grandparent/father/mother/sibling/etc) Would you be interested in having a biblically based grief support group available to your child in Grimes County? yes no Tell us what night of the week works best for your child/children Sunday Monday Tuesday Wednesday Thursday Friday Do you live in the Brazos Valley? Yes No If so, where? Do you attend a church? If so please list the name of your church. How did you hear about us? Social Media Church Group Friend Other Message * Thank you!
