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This registration form is required in order to sign-up for the Guiding Good Choices program. The pre-survey is also a requirement for the program. Please fill them out to the best of your abilities. The information on the registration form will not be shared and will be safely stored and used for grant reporting purposes only. 

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* 1. What is your first and last name?

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* 2. What is your date of birth?

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* 3. What is your address with city, state, and zip code?

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* 4. What is your gender?

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* 5. What is your race or ethnicity?

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* 6. Are you of Spanish, Hispanic or Latino origin or descent?

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* 7. At what email address would you like to be contacted?

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* 8. At what phone number would you like to be contacted?

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* 9. Will you need childcare for youth ages 8 and younger in order for you to attend this program?

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* 10. Parents should identify positive consequences for following the rules as well as negative consequences for breaking the rules.

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* 11. Family meetings to make decisions and rules are a waste of time

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* 12. It is important for family members to practice anger management skills even if it makes them uncomfortable at first.

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* 13. When you are angry with your child its best to tell him/her immediately.

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* 14. Yelling at your children when you are angry with them gets the best results.

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* 15. I have clear and specific rules about my child's association with peers who use alcohol.

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* 16. I have explained my rules concerning alcohol use to my child.

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* 17. I often tell my child how I feel when he or she misbehaves.

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* 18. When my child tells me something important, I let him/her know that I am trying to understand what he/she is feeling.

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* 19. I let my child know I care about him/her while setting limits and consequences.

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* 20. I have discussed our family values with my child on several occasions.

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* 21. Does your child help with family fun activities?

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* 22. Does your child like to get involved in such family activities?

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* 23. Do you have time to listen to your child when he/she wants to talk to you?

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* 24. Do you and your child do things together at home?

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* 25. Does your child go out with other family members to movies, sports events, or other things?

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* 26. Do you have friendly chats with your child?

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* 27. Does your child help with chores, errands, and/or other work?

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* 28. Do you talk with your child about how he/she is doing in school?

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