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WWP Registration

2017-2018 Registration Form

Study runs September 28 – Spring 2018

For women of all ages! Limited morning childcare space is available in the mornings. Children under age one are welcome to stay with their mom.

 

First Name
Last Name
Street Address
City
State
Zip
Phone (Home)
Phone (Cell)
Email

Choose a Course:  Registration includes accompanying study guide as well as operating cost and supplies for the 23 sessions.

Choose Day and Time:

There is limited space available during the morning sessions for children ages 1-6 years. Infants (under age 1) are always welcome to stay with moms.  Children ages 4 and 5 (on Thursday) and 5 and 6 (On Wednesday) may attend a special children’s study.  If you are registering children for the childcare program, please complete the following.  Space will be held for your child when payment is received.  (NOTE: Thursday Evening session does not have childcare):

Child #1 First and Last Name
Child 1 Date of Birth
Child 1 Allergies or Special Concerns
Child 2 First and Last Name
Child 2 Date of Birth
Child 2 Allergies or Special Concerns
Child 3 First and Last Name
Child 3 Date of Birth
Child 3 Allergies or Special Concerns