total # of adults attending (please add their first and last names here also): *
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If you need on-site child care in order to attend include # of children and their ages:
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Ages of children in your care and/ or home: *
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How would you like to receive reminders to attend the workshop?
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How did you hear about the workshop? Examples: Ella White Facebook Page or Friday Folder, my health dept. home visitor, Family Court, dhhs worker, My friend/ word of mouth.
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