CIB Registration

Children in Between Registration

Please complete the form below to register for our Children in Between Class

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Do you have any dietary restrictions we should be aware of? *

Photo Release *

Yes No

Address *

Line 1

Line 2

City

State

Zip Code

Country

By selecting yes, you are granting permission to Families First Learning Lab to take photos and/or videos of you for the purpose of publication, promotion, and/or advertising.

Which class are you registering for? *

4/11, 4/18, 4/25 (6pm-8pm)- Amy Friedman Contact me with information for future classes

How did you hear about us? *

Child care, as available, will be provided for each series. Please list the number of children you would be bringing with you and the ages below. Please include any special needs or allergies as well. *

Do you have any special needs for learning in a classroom? If so, please indicate what your needs are. *

Children in Between operates on an income-based sliding scale fee ($50-$130). After registering, you will be directed to the payment portal which includes further details about the sliding scale. If you have any questions or concerns, please contact jeanice@familiesfirstmt.org

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