email: ParentingwithPRISM@gmail.com
Registration Form for In Person Workshop at Bloom and Grow Creative
Fill out the form carefully for registration
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Type of Registration:
Family (two caregivers attending) $200
Individual (only one person attending) $150
Interested in Babysitting? A separate fee will be charged by Bloom and Grow. Please reply Yes/No below. If yes, please list number of children and ages
*
CLASS SIZE IS LIMITED TO 12 PEOPLE. YOU WILL RECEIVE CONFIRMATION OF REGISTRATION AND PAYMENT INFORMATION VIA EMAIL WITHIN 48 HOURS OF SUBMISSION OF REGISTRATION FORM
Submit
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