Parents Apart Virtual Class Registration Form

 

Parents Apart Virtual Class Registration Form

"*" indicates required fields

Name*
Address*
Email*
Name of Co-Parent*
Child's Name/Age/Gender*
Referral Source*
Price: $80.00
Program fee is non-refundable.
All classes are held from 7:30 pm to 10:00 pm
All classes are held from 7:30 pm to 10:00 pm.
E-news sign up
By checking the box above, I agree to subscribe to DRC e-news which will be sent to my email address above. I understand that I may choose to unsubscribe at any time. DRC does not exchange, rent or sell its mailing list to any outside organization.
TERMS OF REGISTRATION: (A) an email will be sent to address provided with registration confirmation and instructions for attending class; (B) No reminders provided prior to class start date; (C) Notification required 48 hrs prior to date of first class if unable to attend; $15 rescheduling fee will apply for each date change; (D) Failure to attend scheduled class forfeits any money paid.*

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