Child Impact Form

Child Impact Form

Please review before registering:

  1. Co-parents may not attend the same Child Impact Program class and must register separately.
  2. Payment must be made at time of registration. The court ordered fee of $85.00 must be paid prior to being assisgned to a class. Individuals receiving some form of public assistance may be eligible for a reduced rate. Please call (603) 628-7787 to inquire.
  3. You are required to provide your court docket number and court location during registration, and will not receive a certificate of completion after attending the seminar until both are provided.
  4. Registration is not complete until we have enrolled you in a class. A notification packet will be sent to you via US Postal Service Mail to confirm your assigned class date and time. You will not be permitted to attend a class for which you do not have a confirmation letter.

If paying by check, click here to print out form, complete and mail it with payment to Bedford Counseling Associates, 2 Wall Street, Suite 300 Manchester, NH 03101.

*Monday classes are being held at 2 Wall Street while Saturday classes are being held at 401 Cypress Street until further notice

*PARTICIPANTS MUST ARRIVE 15 MINUTES PRIOR TO START OF CLASS. NO LATE ADMISSIONS WILL BE ALLOWED. LATE ARRIVALS WILL AUTOMATICALLY RESULT IN THE NEED TO RE-SCHEDULE THE CLASS.

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