2-Day Nurturing Father's Facilitator Training

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Registration Form for December 2 & 3, 2021
Cost: 350.00 dollars

PAYMENT:
Please make payment to: Nanci Vargas
Mail Payment to: 13723 S. Catalina Ave, Gardena, CA 90247

Email *

First & Last Name *

Phone No. *

(###) ###-####

Your Complete Address *

i.e. 324 E. Crest Pl. Denver, CO. 00323

Email *

Agency *

I grant permission to Nanci Vargas from hereinafter known as the "Media Consent" to use my image (photographs and/or video) and waive any right to inspect or approve for use in Media publications including (Check All That Apply):

Videos

Email Blasts

Recruiting Brochures

By printing my name below I acknowledge that I will comply with the following requirements for the training: 1. I will have a camera and audio on my computers/laptop 2. I have a private space in my home/office to participate in the training. (Remember some training topics may not be suitable for all ears and eyes. Participants should be aware of the presence of others, especially children.) 3. I will be able to attend a face to face, virtual, all day training with breaks for stretching and lunch in the privacy of my home or office. *

i.e. First Last Name

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