2 Day Workshop
Nov 21 & 22
Registering for:
*
Day 1 - November 21, 6pm - 9pm
Day 1: Tuesday, November 21, 6pm - 9pm and Day 2: November 22, 11am - 2pm
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Hghest Level of Education
*
High School Diploma
Associate's
Bachelor's
Master's
PhD
Other
Select all that applies to you
*
Parent of Elementary school student
Parent of Middle school student
Parent of High School student
College Student
High School Student
Other
*
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Move Workshop Day 1 + Refreshment
Tuesday, November 21, 6pm - 9pm
$
Free
Move Workshop Day 1 & 2 + Lunch
Day1 Tuesday, November 21, 6pm - 9pm and Day2: Wednesday, November 22, 11am - 2pm
$
25.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
*
Signature
*
Date of Consent
*
-
Month
-
Day
Year
Date
Submit
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