Motherhood & More Group
You will receive a confirmation of your registration. Please let us know if your plans to attend change.
Location: Swift River School, 201 Wendell Rd, New Salem 5:30 - 6:30pm on November 10th
Adult Name (Parent, Guardian, Grandparent, etc)
*
First Name
Last Name
Additional Adult Name (Parent, Guardian, Grandparent, etc) if applicable
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Town you reside
Street Address
Street Address Line 2
TOWN NAME
State / Province
Postal / Zip Code
Home Language
Will you view the virtual presentation in person at Shutesbury or virtually from 6:00 - 7:00pm from home? (Please let us know if your plans change)
*
Please complete for all children attending in person with you. Children will be in the room with us.
If in person will you participate in the pizza and salad dinner at 5:30? (this helps us to know how much to order. We will have a vegetarian pizza and meat pizza)
Please Select
Yes
No
Please let us know if you have questions or additional information you would like to share.
Submit
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