Parenting Enrichment Course Registration

Parenting Enrichment Course Registration

Fill out the form carefully for registration to secure your spot in the next class. Parenting Classes are free to Greenville County Residents. Residents in other South Carolina Counties must pay here using a debit or credit card or bring cash or a money order to our office. For questions about parenting courses for English speaking parents, contact Lynn Hooper, Parenting Director, at (864)-467-4099 or lynn@justsaysomethingsc.org! For any questions about parenting courses for Spanish Speaking parents, contact Mally Mitchell, Parenting Coordinator, at (864) 467-4099 or mally@justsaysomethingsc.org.
Participant Name*

First NameLast Name
Participant E-Mail Address*
example@example.com
Participant Phone Number*
Please enter a valid phone number.
Participant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Relationship to Child*

MotherFatherGrandparentGuardianOther
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Would you like to register an additional participant for this course?

YesNo

Additional Participant Information

Please provide the following information for the second parent or guardian that will be participating in the course.
Participant Name

First NameLast Name
Participant E-Mail Address
example@example.com
Participant Phone Number
Please enter a valid phone number.
Participant Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Relationship to Child

MotherFatherGrandparentGuardianOther

Additional Information

Please provide the following information.
Number of children in family
Our courses are for PARENTS and GUARDIANS only. Unfortunately, children may not attend.
Ages of children in family
Have you previously taken a parenting class? If so, where?
How did you hear about Just Say Something?

DSS or Family CourtAttorneyWebsiteWord of MouthOther
DSS or Family Court County
Social Worker's Name

First NameLast Name
Social Worker's Phone Number
Please enter a valid phone number.
Social Worker's Email Address
example@example.com
Did DSS specify which course to take? If so, which one?

Additional Participant Information