To Register To register, simply fill out the following form! Name(required) Street Address(required) City(required) State(required) Zip Code(required) Phone(required) Email(required) Date of Birth (00/00/0000)(required) Emergency Contact Name(required) Emergency Contact Phone(required) How did you hear about DivorceCare? Please share a little information about your separation or divorce. Child care is by request only. If you need this service, please list the names of children attending, genders, ages and present school grades. We will arrange child care on site. A one time only fee of $15, which covers the workbook and other expenses during all 13 weeks of sessions, will be due at the start of the first meeting. By clicking “submit,” you agree to pay this fee. If you are unable to meet this requirement, please contact the DivorceCare Coordinator Tim Evans to explore further options. He can be reached via email at email@example.com. Submit If you prefer to print and send in your registration by mail, you can do so by printing the form here and mailing it to: PO box 1476, Dublin, 43016.