CCFH Post Adoption Rec & Respite- Round-A-Bout 2 (880 Elm Street, Fayetteville, NC 28303 )- Friday, January 31, 2020 @ 5:00pm-7:00pm

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Please complete the form below to register. Free dinner will be provided! Spaces are limited and will be confirmed via email. Once spaces fill up, you will be assigned to a waitlist and will be notified if a slot comes available.

Parents are welcome to attend without their children to enjoy the support and company of other parents!

Email Address *

Your First and Last Name *

Phone Number *

County of Residence *

Anson

Durham

Cumberland

Harnett

Hoke

Johnston

Lee

Montgomery

Moore

Richmond

Scotland

Wake

Other:

How did you hear about this event? *

On CCFH list serve (email from Kate)/from CCFH staff

From my DSS social worker

From a private agency social worker

From a friend

Internet search

Other:

Type of adoption (check all that apply; please note this information is required from our funders at NCDSS) *

Adopted from US foster care

Adopted through private agency

International adoption

Adopted child of friend or family member ("kinship adoption")

Stepparent adoption

Other:

Required

Number of adults attending *

Number of children attending *

Name, age, and gender of each attending child

Please list first name, age, and gender of each attending child. Please note that children under 3 must be accompanied by an adult. If you are attending more than one event please note which children are attending each event.

Any dietary restrictions or special instructions? *

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