PSTEP Registration Form

PSTEP Registration Form
PSTEP offers an 8-week program for parents/caregivers and their teens ages 13-18 that embraces our Enon Value Cross 5 core values as the foundation for character development and strengthening family communication and relationships through the application of biblical principles and engaging and interactive peer groups and conversations.

Our next Cohort will be held:
- Dates: Thursdays, January 23rd - March 6th, 2024
- Time: 6:00 PM - 8:30 PM
- Location: Enon East, 2800 W. Cheltenham Avenue, Phila., PA
More information and details will be provided! You may also email us at pstep@enontab.org. We look forward to your family joining us!
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Ex. (215) 222-2222
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am attending the program as a:*

Parent/CaregiverYouth Participant
I am between the ages of:*

131415161719 -2425-4445-6465+Prefer not to answer
I am an:*

Enon MemberNon-Enon Member
What is your member number?
Do you have dietary restrictions or food allergies?
Comments/Questions
ask questions or make comments
Do you have additional family members that will participate? If so, you may add up to 3 additional family members on this form.*

YesNo
2nd Participant's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am attending the program as a:

Parent/CaregiverYouth Participant
If you are a parent or caregiver please provide your relationship to the teen:
I am between the ages of:

131415161719 -2425-4445-6465+Prefer not to answer
I am an:

Enon MemberNon-Enon Member
What is your member number?
Do you have dietary restrictions or food allergies?
3rd Participant's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am attending the program as a:

Parent/CaregiverYouth Participant
If you are a parent or caregiver please provide your relationship to the teen:
I am between the ages of:

131415161719 -2425-4445-6465+Prefer not to answer
I am an:

Enon MemberNon-Enon Member
What is your member number?
Do you have dietary restrictions or food allergies?
4th Participant's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am attending the program as a:

Parent/CaregiverYouth Participant
If you are a parent or caregiver please provide your relationship to the teen:
I am between the ages of:

131415161719 -2425-4445-6465+Prefer not to answer
I am an:

Enon MemberNon-Enon Member
What is your member number?
Do you have dietary restrictions or food allergies?
Should be Empty: