Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Court Required? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Court Attestation {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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  If i am required to attend a court mandated Parenting Class, I acknowledge that this is NOT a court approved class and I will not be accepted for enrollment.  If I am not forthcoming of court requirement and enroll, I WILL NOT receive documentation as proof of attendance, will be terminated from class immediately, and there are no refunds.  

 

Choice {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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I acknowledge that completing this form is for general information inquiry(s) and not for use for Medical concerns or emergencies. It also does not formulate an agreement for services. I am also aware that Internet email is not completely secure nor confidential. This form is not encrypted/secure. I am over the age of 18 years old. 

I acknowledge I am honest and truthful in my responses in this form.

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Court Required? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Court Attestation {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Choice {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Cognito Forms{{ Cognito.resources["powered-by-cognito"] }}