TriCity Family Services

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Star K-3 Workshop - Guiding the Way Through Friendship. Each grade level's curriculum is specifically designed for them.

Date: Saturday, March 7, 2026

Time: 9:00 AM - 11:30 AM (Check-in starts at 8:45 AM)

Location: Geneva Middle School South, 1415 Viking Drive, Geneva, IL 60134

Register your children in kindergarten through 3rd grade below to participate in the Star K-3 Workshop (with curriculum by Navigate Adolescence) brought to you by TriCity Family Services and the Geneva Coalition for Youth with the support of Geneva CUSD 304. The Star K-3 Workshop is a fun-filled workshop that focuses on helping children develop the basic building blocks of friendship with grade-specific activities.

Please note that ONLY a parent/guardian of a Star K-3 Workshop participant may complete this registration due to the permission/waiver that is included.

Registration Fee for Star K-3 Workshop participants:
$20* per child

Please complete your registration below. Once your transaction is complete,
you will receive a receipt via email from Acceptiva.

*Need-based fee reductions are available for those who qualify. If you want to request a fee reduction, please email compass@tricityfamilyservices.org to request a code that must be used in this on-line registration.

OPTIONAL: TriCity Family Services will present a free Parent Presentation, "Growing Joy to Build Resilience" from 9:05-10:05 AM in the cafeteria during Star K-3. The presentation will provide practical tips for parents/guardians to use immediately to assist their preschoolers through third graders to:

Develop happiness that endures beyond circumstances
Practice joy-promoting habits
Approach emotions with a resilient mindset

Qty

Description

Amount

Total

Star K-3 Workshop Registration(s) per K-3rd-Grade Child

$20.00

---

CODE to REGISTER with an ALTERNATIVE FEE or SCHOLARSHIP

---

Optional Parent/Guardian Presentation Registration(s) for "Growing Joy to Build Resilience" 9:05-10:05 AM

$0.00

---

Total: $0.00

Star K-3 Workshop Information

Child's First Name: *

Child’s Last Name: *

School – Please choose from a list below or type in the “Other School” box for a school name that is not listed.

Geneva CUSD 304 Schools:

St. Charles CUSD 303 Schools:

Batavia Public School District 101 Schools:

Kaneland CUSD 302 Schools:

Central CUSD 301 Schools:

Private Schools:

Other School:

Please type the full name of the school - Homeschooling is listed above as an option in each district.

Grade Level: *

Has your child attended a Star K-3 Workshop in the past?

Attending STAR K-3 for the: *

List Same-Grade Friends You Would Like to Be In Your Child's Group OR Type "Meet New People": *

Please invite the friends you list. Additional participants may be added to complete the group.

Dietary & Medical Info to better serve your child: *

Vegetarian, Food Allergy, or Medical Condition (severity and how it is being managed) – or type NONE. *Please note that children with severe food allergies will need to bring a lunch & a snack for the day of the event.

What do you want the facilitators of Star K-3 Workshop to know about your child to help make the best possible workshop experience for your child?

Helpful Info about Your Child:

Additional Information

Participant Address: *

City, State and Zip: *

When TCFS seeks grants to help offset the costs of providing Emotional Wellness Programs such as Star K-3 Workshop, TCFS is often asked to report on the numbers of participants per township.

Township *

To help us with a current grant application and with future program planning, do you have one or more children age 5 years-old or younger?

Children age 0-5:

Telephone of Parent/Guardian to contact, if necessary, about the registration, but please note that email will be the primary method of communicating event updates.

Telephone: *

Please add Star K-3 Workshop's email address: compass@tricityfamilyservices.org to your email contact list to try to avoid email being misdirected to your Junk mailbox.

E-mail: *

Parent/Guardian e-mail to share event updates.

Emergency Contact: *

Relationship to Participant/s: *

Phone: *

Phone number where you can be reached during the event/Emergency Contact.

Alternate Emergency Contact:

Relationship to Participant/s:

Phone:

Alternate Phone number where you can be reached during the event/Emergency Contact

PERMISSION FORM FOR STAR K-3 WORKSHOP AND LIABILITY WAIVER

I give my permission for my child/children to attend the Star K-3 workshop on 3/7/2026 (or on a rescheduled date if the Star K-3 workshop on 3/7/2026 must be cancelled and rescheduled as a result of inclement weather) at Geneva Middle School South. I hereby release and indemnify Navigate Adolescence, Inc., and its officers, TriCity Family Services (TCFS) and its officers, agents, employees, and volunteers, the Geneva Coalition for Youth and its officers and volunteers, Geneva Middle School South, Geneva CUSD 304, St. Charles CUSD 303, Batavia Public School District 101, Kaneland CUSD 302, Central CUSD 301, East Aurora School District 131, West Aurora School District 129, and the event sponsors and volunteers from any liability arising from any claims, damages, or injuries of any kind or nature whatsoever from my child/children's participation in this event. I grant permission for the administration of first aid to my child/children by the people in charge of the event as their judgment deems advisable and that I will be responsible for payment of any medical services rendered. I understand that I will be promptly notified in the event of any serious accident or illness. In the event I cannot be reached, I hereby give permission to the people in charge of the event, emergency personnel and physicians to secure proper treatment and to order injections, anesthesia, or surgery if deemed necessary for my child/children. I also recognize that my child or children will be withdrawn from the event if TriCity Family Services facilitators feel that they pose a risk to the safety or well-being of or a significant distraction to the participants in the Star K-3 event.

I give consent to the use of my own or my child/children's photograph/image, voice, written, and or verbal statements, by Navigate Adolescence and TriCity Family Services in publications, videotaping, advertisements, brochures, websites, etc. I agree that Navigate Adolescence and TCFS may use my own or my child/children's photo/image without my permission for lawful purposes including the above. I further acknowledge that there is no agreement or promise on the part of Navigate Adolescence and TCFS to compensate my child/children or me in any way for the use of these photographs/images. I hereby release Navigate Adolescence and TCFS from any and every personal or proprietary claim, demand, right or cause of action of whatever kind or nature, either in law or equity arising from the use of these photographs/images. I have read and fully understand the terms of this release.

The information presented at Star K-3 is provided as a service to the community. The information shared is not intended to serve as, or substitute for professional counseling. All information shared will be kept in strict confidence by all TCFS and Navigate Adolescence personnel unless matters which indicate possible harm to or by a participant are revealed. All Star K-3 event staff and volunteers are mandated reporters. Confidentiality among the children participating in Star K-3 will be encouraged but cannot be guaranteed.

Permission and Liabilty Waiver: *

I have read and agree to the terms of the above “Permission Form for Star K-3 Workshop and Liability Waiver”.

If you chose not to agree, then you will not be able to use the online registration process for the Star K-3 Workshop If you have questions, please email compass@tricityfamilyservices.org or call Michelle Clark, LCPC, NCC, Director of Emotional Wellness Programs at TriCity Family Services (630)232-1070, ext. 336, or visit www.tricityfamilyservices.org for more information about the Star K-3 Workshop.

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

E-mail: *

A receipt will be e-mailed to this address.

Once your transaction is complete, you will receive a receipt via email from Acceptiva - SAVE THE ACCEPTIVA RECEIPT AS PROOF OF REGISTRATION.

Questions? Call: Michelle Clark, Director of Emotional Wellness Programs at TriCity Family Services (630)232-1070, ext. 336. Or, email compass@tricityfamilyservices.org. You can also visit www.tricityfamilyservices.org for more information about the Star K-3 Workshop.

Your Payment Information

Name on Card:

Card Number:

Security Code:

Expiration Date: