Moms Connect

We ask your permission to collect further information throughout the program including this registration form, surveys and participation. We will use this information to better understand the families we serve, report on program outcomes, and continuously improve our programs to better meet your needs. Your information will be kept confidential. Your participation and insights are invaluable in helping use create a more impactful and enriching experience for all parents involved.
Thank you for your cooperation and support.

Registration for Moms Connect

Will you need childcare during the program? *

Yes No

Have you attended a Families First parenting program before? If yes, which one? *

Name of Child (1) *

First

Last

Age *

Name of Child (2) *

First

Last

Age *

I understand that photos and/or videos may be taken during the event. I give permission for these images of myself and my child(ren) to be used for promotional or documentation purposes by the event organizers without compensation. *

Yes No

Would you like to receive monthly newsletters sharing upcoming Families First programming in Lake County? *

Yes No

Name of Child (3) *

First

Last

Name of Child (4) *

First

Last

Age *

Check which class(es) you will be attending: October 2nd's class is FULL. I apologize. *

October 9: Yoga October 16: Cooking October 23: Beading October 30: Soak at Wildhorse Hot Springs

​Registration for Moms Connect

Registration for Moms Connect