Parent Name:



Preferred Location:
Reasons for Enrollment:
Goals You Would Like To See Achieved:
Physician Name:
Physician Practice, Group or Hospital:
How did you hear about ProActive Kids?:
how to register


​PROACTIVE KIDS IS NOW WORKiNG DIRECTLY UNDER ADVOCATE's HEALTHY ACTIVE LIVING PROGRAM. We encourage you to contact healthy active living. If you sign up using the form attached, we will direct you to HAL. 


 IF YOU ARE REGISTERING MULTIPLE PARTICIPANTS, PLEASE USE A DIFFERENT FORM FOR EACH CHILD. YOU WILL RECEIVE AN EMAIL WITHIN 10 MINUTES OF REGISTERING TO CONFIRM WE RECEIVED YOUR REGISTRATION.  IF YOU HAVE ANY QUESTIONS ABOUT THE PROGRAM, PLEASE VISIT OUR FAQ PAGE.