Parenting Your Spirited Child Registration

Name

Phone Number

Email Address

Mailing Address

Is there anything else you'd like us to know?

How did you hear about this workshop?

Do you need childcare? Do you need childcare? Yes No

Child's Name and Date of Birth

Child's Name and Date of Birth

Child's Name and Date of Birth

Child's Name and Date of Birth (If you have more than four children please call to set up childcare.)

Do you need a certificate ($10 apiece)? Do you need a certificate ($10 apiece)? Yes No

After submitting this form, go back to our Workshops page and scroll to bottom to pay for your certificate.