New Parent boot camp

Father/Guardian Full Name

Email

Mother/Guardian Full Name

Parent/Guardian Email

Phone Number

Area CodePhone Number

How would you prefer to be contacting?

Please select the date to sign up Parent Boot Camp Class.

Each class has a min. of 15 families / maximum of 20 registered families. Parents must attend to receive gifts and enter to win grand prize.

The following are the requirments to be considered to received $100.00 toward your utility bill.

1. The individual must sign up online.

2. The individual must be present on the date of selection.

3. The individual must present a curently utility bill. One bill per household.

4. Families must submit their utility bill at the beginning of the event.

5. The five families will be randomly selected at the end of the event.

I acknowledge and understand all the requirements listed above.

Is English your second language?

These following organizations offer free resources. Select which one you would like more information about?

Of the following courses, which one best addresses your current need?

How did you hear about us?

Comments

Parent Boot Camp is sponsored by Jefferson City Diapers.

The Jefferson City Diapers inventory is supplied by donations from supporters across the Unites States, local community, sponsors, and partners. Thank you to our sponsors; private donors, Bibleway Community Church and Walmart!