Virtual Parenting Play Group Registration Form

Virtual Parenting Play Group Registration Form | 2021-2022

Bank Street Family Center
To register for one or both sessions of our virtual parenting play group, please complete the fields below. There are five meetings per session, with a fee of $200 for one session or $350 for both sessions. Each group will be limited to five families. All meetings take place on Wednesday evenings from 8:00 PM to 9:00 PM EST on the dates listed. Group facilitators will distribute links to our virtual meeting space in advance of the first meeting.
How many Parents/Guardians from your family will be attending virtual play group meetings? *

1 2
Parent/Guardian Attendee 1
Full Name *

First Name Last Name
Email Address *
example@example.com
Parent/Guardian Attendee 2
Full Name

First Name Last Name
Email Address
example@example.com
Your Child
Your Child's Name *

First Name Last Name
Your Child's Date of Birth *

Month Day Year
Date
Session Selection
Session 1 - March 30; April 6, 13, 20 and 27 | 8:00 PM - 9:00 PM
Session 2 - May 4, 11, 18 and 25; June 1 | 8:00 PM - 9:00 PM
Choose your session(s):
Selection count
Price
Payment
Please note that AmEx is not an accepted method of payment on this form.

Total

USD Total cost

Virtual Parenting Play Group Registration Form | 2021-2022