Caregiver Connection - Registration
Name
*
First Name
Last Name
Birthdate (Optional)
-
Month
-
Day
Year
Date
I would like to receive emails about other RPPP groups and events:
Yes
No
Address (Optional)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What ages of children do you care for:
*
Birth to 2.5 years
3-5 years
School Age (Under 12)
Teenager
Other
What do you hope to get out of Caregiver Connection? Please select all that apply
*
Parent Education
Friendships
Support
Community
Other
By registering for Caregiver Connection you are also registering to be a non-voting member of Rutland Parent Participation Preschool Society. Non-participation for a calendar year will result in termination of membership, at which time re-application would be needed. There is no cost or time obligations to membership, however there is a code of conduct we expect members to adhere to when interacting with or attending RPPP events. Failure to follow expectations set in the code of conduct may result in termination of membership as outlined in our By-Laws.
*
I understand and agree to follow the Code of Conduct (below)
Submit
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