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Rise and Shine Family Connection Form
đź’™ Welcome to our Family! đź’™
We're so glad you're here.
Welcome to the Rise and Shine community!
Website:
www.riseandshine.llc
Instagram:
@Rise2shinelife
TikTok:
@riseandshinellc
Parent/Guardian / Adult Full name
*
Email Address
*
Phone Number
*
Preferred Method of Contact
*
A
Email
B
Text
C
Phone Call
Child / Young Adult's First Name
*
Age / Life Stage
*
A
Early Childhood 0-5
B
School-Age 6-12
C
Teenager 13-17
D
Young Adult 18-25
E
Adult 26+
Is there anything specific you'd like to share about your loved one's unique abilities, interests, or diagnosis?
(Paragraph - Optional - e.g., Apert syndrome,
Cerebral palsy
, Autism, learning disabilities, or just what they love to do!)
*
Would you like to register your child/young adult for Leo's Perfectly Different Club?
*
A
Yes! Please add us to the club...
B
Not right now, just keep me updated.
How would you like to interact with us?
*
Receive newsletter
Hear about upcoming local South Florida events
Virtual Parent Workshops
Volunteer or collaborate
1:1 Coaching
Advocacy support
Are you looking for direct support or 1:1 coaching right now?
*
A
Yes, I need immediate help. Please have Elsie, Thaliah or Geno reach out.
B
I'm interested in learning more, but no rush.
C
No, I'm just here for the community.
Areas of support needed
IEP/School Meetings
Step Up Scholarship Help
Transition Planning
Parent Self-Care
Health & Fitness Coaching
Finding local South Florida resources
Submit
