Parent Education Registration Form

You are only allowed to register yourself.
Registration fee is $75.00 and is non-refundable, payable by VISA, MasterCard, or Discover.
Pre-registration and pre-payment are required to attend this class.
If you pay online, you will receive an email confirming your class date a few days after registration is submitted.
If you are not paying online, call us at 503-655-8700 to arrange payment before you will be assigned a class date.
Entry to the class is not allowed after 5:30 p.m. when the doors close, and there is a $75.00 fee to reschedule this class.
To avoid paying a $75 rescheduling fee, please give us a 24-hour notice to reschedule the class.

1. Personal information

Legal first name

Legal middle name

Legal last name

Date of birth

Mailing address

City

State

Zip

Primary phone

Phone type

Home

Cell

Work

Other

Secondary phone

Phone type

Home

Cell

Work

Other

E-mail

Required to receive confirming email when paying online

Please keep my contact information confidential from the other party

Yes

Have you used any other services offered by Clackamas County Resolution Services?

Yes

2. Class day and date preference

Primary choice

Secondary choice

Please note: When selecting a class date, please be aware that our classes often book up several weeks in advance. The fact that a class date shows up in the drop down menu does not mean that it is still available.

3. Court case information

Case number

Filing type

Filing date

Filed in

I am the

Other party's legal first name

Other party's legal middle name

Other party's legal last name

4. Safety information

Resolution Services will register parties to the same court case in different classes if either party answers "yes" to any of the questions listed below.

There has been a restraining order in effect between the other party and me in the last year.

Yes

There has been domestic violence between the other party and me in the last year.

Yes

There is a No Contact Order (in a criminal case).

Yes

I would prefer to attend a separate class from the other party.

Yes

5. Accommodations information

Do you require interpretation services?

Yes

If yes, language:

Do you require any other accommodations?

Yes

What accommodations do you need?

6. Payment waivers - register online and do not make an online payment

At the time I filed, I qualified for and received a fee waiver from Clackamas County Circuit Court

Yes

* Participants may be eligible for a fee waiver for the Parent Education Program if the party signed and presented a verified affidavit of indigency to the Court and it was granted by the Court.