YA Grief will be offered every 1st Monday of the Month and every 3rd Monday of the Month!

Feel free to attend any Monday you like, we will send you a text reminder before each group. 

Registering only once is required. 

We would kindly ask that you please fill out your address information

for your first visit only.  After registering one time just fill out your name.

Thank you! 

* Required Fields
Contact Information
* First Name 
* Last Name 
  Address 
  Address 2 
  City 
  State/Province 
  Zip/Postal Code 
  Home Phone 
  Cell Phone 
  Email 
  Date of Birth 
(mm/dd/yyyy) 


Attender Information
  How did you hear about us? 
  Name of Special Person 
  How did your special person die? 



Privacy Policy
We keep your personal information private and secure. When you submit this form, your name, contact information, and any additional information will be available only to our organization.

Contact Us: Billy's Place •• 21448 N 75th Avenue Suite 6, Glendale Az 85308 •• 623.414.9838 •• info@billysplace.me

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