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Agreement.pdf

Handbook.pdf

First name

Last name

Email (for login, events, and newsletters)

Phone

Address, City, State, Zip

Yes, I live in Hamilton County, IN.

Birthday (Thr!ve Member must be 18-30 years old)

Month

Day

Year

High School Affiliation (please indicate if still in school)

Parent/Guardian Full Name

Parent/Guardian Phone

Parent/Guardian Email

Personal Reference for Potential New Thr!ve Member (ie: case manager, therapist, etc) Please provide NAME and EMAIL!

How did you hear about Thr!ve? Please provide a name.

Has the potential New Thr!ve Member ever been charged and/or convicted of a criminal offense?

By checking this box, I understand that Thr!ve is NOT a respite program and is NOT responsible for any needs, including but not limited to, emotional, physical, behavioral, or medical.

Members that need support of any kind must provide their own