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CGT Support Group Participation Consent

By checking the box I, the parent of minor child(ren), hereby consent for my child(ren) to participate in and facilitated by CGT Support Groups, for teens who have difficulties coping with bullying behaviors and its affects.


Description of Services: The purpose of the program is to offer education and support to help children who are struggling with their feelings of bullying behaviors or being their target and other life events. I understand that this group does not provide counseling but is an educational and support program designed to teach skills, facilitate self-awareness and confidence, promote new behaviors, and demonstrate how to effectively deal with some of the issues presented by bullying. The group facilitators have found that when working in groups, children gain support from others who are experiencing similar situations or who have adjusted well after experiencing a similar situation in the past. I am also aware that even though this group is led by facilitators, it will not provide group counseling.


Confidentiality: I understand that in order to encourage children to participate actively, parents and outside observers will not be allowed to attend to include parents. This is to help children feel safe about sharing. I understand that participation in the group is completely voluntary, and confidentiality is addressed and respected. I understand the exception to this is the group facilitator’s legal and ethical responsibility to take appropriate action in the case of an individual intending to do harm to self or others, if abuse or neglect is suspected, or if illegal activity is reported.


I understand that the program may be described in written publications for services CGT provides. I give my consent for CGT to use artwork, images or quotations made by my child in support of group brochures, literature, or other public relations activities. My child will not be identified by his or her real name.


CGT recommends not placing 2 or more children that live in the same household, in the same sessions. Children would not feel comfortable speaking about themselves in the presence of a sibling.

Please ensure that both the Booking Form and Consent To Terms & Conditions are completed within 10 days of group session.

Terms and Conditions

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