Wellness Warriors Registration

Wellness Warriors

Wellness Warriors will build resiliency and increase coping skills for youth to better manage stress, anxiety, and other common challenges. Wellness Warriors is designed for early intervention while providing support in a small group atmosphere for youth ages 9 to 12. Wellness Warriors will include mindfulness activities, coping strategy workshops, and offer peer support. Youth will have the opportunity to express their feelings, share their experiences, and encourage others who have faced similar challenges. Registration will be completed through Big Brothers Big Sisters Kawartha Lakes - Haliburton in collaboration with CHIMO. The program will run Mondays from 4pm to 530pm beginning May 5th 2025 until June 30th 2025 at CHIMO, and will be primarily facilitated by Big Brothers Big Sisters agency staff. There will be no group programming on Monday May 19th 2025.

YOUTH INFORMATION

Youth Name(Required)

First Last

Preferred Name

Date of Birth(Required)

Gender(Required)

Preferred Pronouns

Address(Required)

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

Please describe any mental, behavioural or physical diagnoses/behaviours your child experiences:(Required)

(eg. Anxiety, ADHD, Asthma, Panic Attacks, Stress, ASD, FASD, Learning Disabilities, ODD, etc.)

What are some challenges your child is currently facing?(Required)

Does your child have any triggers or situations that typically cause distress?(Required)

Are there specific topics or skills you'd like to see addressed in this group?(Required)

What are your primary goals or hopes for your child in joining this group program?(Required)

Please list any food allergies your child has:(Required)

Any additional information that would you think we should know about your child:(Required)

PARENT/GUARDIAN INFORMATION

Name(Required)

First Last

Relationship to Youth(Required)

Address

(If different than youth's)

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

Phone(Required)

Email(Required)

Phone

This field is for validation purposes and should be left unchanged.