Susanne Smoller Conference 2023 Presents: Youth & Family Wellness from the Inside Out!
Atkinson Intermediate School
58 Seaman Ave
Freeport, N.Y. 11520
Sign in to Google to save your progress. Learn more
Susanne Smoller Conference Youth and Family Wellness from the 
Taking care of the MIND & BODY from the Inside Out reminds us to embrace the wholeness of ourselves! There is something for EVERYONE ages 8 and above at this full day conference experience! 
Ages 8 - Adult 
***All children MUST be accompanied by an adult***
First Name *
Last Name *
PTA Unit Name *
PTA Unit Number *
Enter your PTA Unit Number in this format example 10-### *If you do not represent a PTA, please enter 00-000
School District *
Email *
Phone Number *
Please enter the number in this format (xxx) xxx-xxxx example (516) 321-1234
Number of Adult Attendees  *
Number of Attendees (under age 18) *
Please list ANY ALLERGIES (If no allergies please indicate -"None") *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Nassau Region PTA. Report Abuse