Thank you for your interest in our workshop! Please complete one registration form for each person attending.
Name
*
First Name
Last Name
Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Which break-out session will you attend?
*
Teen/Young Adult
Caring Adults
There will be an optional meal at 5pm, following the breakout sessions. This meal is free, but not mandatory. Will you be joining us for the meal? (Menu: Taco Mama with shredded chicken and ground beef)
*
Yes
No
Please note: Childcare is not provided for this event.
Just a couple more questions...
How did you hear about event?
Would you like to receive updates about future events and resources?
Yes, please keep me informed.
No, thank you.
Register
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