Strengthening Families Registration
Strengthening Families 10-14:
Wednesdays, July 11 - August 15, 2018 OR Fridays, July 13 - August 17, 2018
St. Mary's Catholic Church, 132 W. Butler St., Manchester, Iowa 52057
5:30 PM Dinner
6-8 PM Program
This program is open to all families/adult caregivers with youth ages 10-14 who would like to register.
Pre-registration is required.
Free dinner for all participants and facilitators.
Child care and transportation is available upon request.
Space is limited to the first 10 families who register.
Parent Guardian Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email *
Your answer
Which method would you like to receive reminders and weather cancellations? *
Required
Program I would like to attend
Names and ages of children 10-14 years old. *
Your answer
Names and ages of children (under 10) who will need childcare.
Your answer
Please list any family food allergies.
Your answer
Let us know if you need transportation.
Your answer
Please list any special accommodations or things that would be helpful for the facilitators to know.
Your answer
Photo Release: I hearby grant full permission to Helping Services for Youth & Families to use my/my children's image or quotes for educational and promotional purposes. I waive any rights of compensation or ownership for the publishing of the image/story/quote. *
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