Request edit access
Parenting in 2018 - Workshop Series Registration Form
Adults/Parents only (grandparents are also welcome!!) Please fill out the registration form completely below for any, or all, workshop courses you plan to attend.

Workshop Location Address:
"eTeachingMe"
4230 Williams Dr., Building #2
Georgetown, TX 78628

COST/FEES:
$20.00 per course
SAVE: $99 full 6-week course ($20 OFF value)

We look forward to having you join us for learning and fun at eTeachingMe!

Adult Enrolling - First & Last Name *
Your answer
Second Adult Enrolling (spouse) - First & Last Name
Your answer
Phone Number 1 *
Your answer
Email Address *
Your answer
Home Address *
Your answer
Please select the course session (dates) you are wanting to attend & register for. *
Adults only. These adult parenting education classes meet on Sundays, from 5 to 6 pm. PLEASE NOTE: If you are wanting to attend more than 1 course, but not the full 6-week series, please select "OTHER" and write in which dates/course topics you are wanting to register for. Thank you!
Why are you interested in attending this parenting class? *
Tell us How.... *
We love to know where our families come from. Please select how you heard or found out about us below!
Payment Policy Consent *
I understand that I am to pay in full for the workshops I have selected to attend before January 20th. If I fail to pay by the 20th, my spot may not be secured and will be given to someone on our wait list. I understand that all fees are non-refundable.
Credit Card Policy *
By submitting my credit card information through the secure online registration process using the PayPal payment processing system, I authorize eTeachingMe to automatically charge my card for fees due. I understand I will be sent an invoice to the email address I list on file, to make payment with my card easily using eTeachingMe's online system, or I have the choice to pay by cash or check.
Release of Liability *
By reading and signing this form, you are agreeing and aware that you are engaging in activities with Love N Learn At Home, LLC dba eTeachingMe that include but are not limited to physical exercise and use of equipment, facilities, training and learning instruction. Some of our activities could cause injury to you or others. You are voluntarily participating in these activities and assume all risks of injury and liability that might result. You agree to waive any claims or rights you might otherwise have to pursue, Legal or other action against Love N Learn At Home, LLC dba eTeachingMe, the facility's owners, officers, employees, or agents for any reason. You have carefully read this waiver and declare you are sufficiently physically fit for any of our activities in which may require physical abilities and exercise.
Signature of authorized parent/guardian *
By signing below, you are agreeing to register the above named person for our enrichment learning classes. You have read and fully understand all class details, descriptions, and policies as stated above. This signature verifies understanding and acceptance of this registration.
Your answer
Signed this day
MM
/
DD
/
YYYY
Signed at this time
Time
:
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms