"Protect & Play" Workshop Registration
December 29th | 12-2:30pm | Mission Kids - Pottstown (929 Willow St., Pottstown PA)
How did you hear about this event?
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I was referred by a friend!
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Please provide the name of the person that referred you
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Caregivers/adults will attend the 2-hour "Smarter Parents" workshop while children ages 5 to 13 participate in Mission Kids' body safety lessons and special crafts.
Plus, don't miss out on our "Refer a Friend" incentive!
Your Name
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First Name
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Your Email
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Your Address (to send your gift card)
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"Smarter Parents" is designed for caregivers of children under the age of 13. Please confirm your role:
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I am the parent/caregiver/guardian/other adult in a child's life
This does not apply to me
Are you registering any children ages 5-13 for the personal safety lesson(s) and staff-lead activities?
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Yes
No
Please list the name(s) and age(s) of ALL children attending the workshop:
Are you registering another caregiver/adult household member for the "Smarter Parents" workshop (This is NOT the referral bonus!)
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No
Additional Caregiver Name
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Additional Caregiver Email
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Additional Caregiver Address
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Please confirm this person's role:
Parent/caregiver/guardian/other adult in a child's life
This does not apply
Mission Kids provides a variety of adult, professional, and community based prevention education trainings to help keep kids safe from harm. Would you like a member of our team to contact you about additional workshops?
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Yes please
No thank you
Do you or anyone listed above require accommodations for this workshop?
Refer a Friend & Earn!
By attending this event, you're already getting a $20 Amazon gift card. Refer a friend and earn an additional $10 gift card if they participate, too!
Are you referring a friend (non-household member) to attend Smarter Parents on 12/29?
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Yes
No
Name of person you're referring:
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Email address of person you're referring:
example@example.com
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