FAMILY SEMINAR REGISTRATION FORM

Foster, Adoptive, Kinship, Social Worker, Other?

Adoptive Parent
 Please Select All That Apply:
Foster Parent
Adoptive Parent
Kinship Provider
Social Worker
Other

Meal Selection

Lunch Provided (Children will have pizza)
 
 

Workshop Selections

Attendee #1 *
Workshop AWorkshop BWorkshop CWorkshop D
Please select a choice
Attendee #2
Workshop AWorkshop BWorkshop CWorkshop D
Please select a choice

Child Care / Teen Program

CHILD #1
CHILD #2
CHILD #3
CHILD #4
CHILD #5
CHILD #6
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Free child care is available at Take-A-Break Child Care Center (across the street from the Seminar).  Pre-registration is required and child care will be provided on a first come, first served basis.  There is limited space available.

Because your child(ren) will not be on site of the seminar, full registration paperwork for child care will need to be filled out prior to leaving your children.

If your child needs medication during the seminar, you will have to bring the medication in its original container and complete a medication form.

For additional information about child care or to confirm your registration, contact Kim at 269-660-0448 or kharris@fecfamily.com.

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