Child Care Request-How to Think Like a Baby
May 21, 2018, 6:30-8:00 pm, LBCC Tripp Theater-Takena Hall 6500 Pacific Blvd SW, Albany
Please plan to arrive 15 minutes early to get your child settled in care.

First Name *
Your answer
Last Name *
Your answer
Email
Your answer
Phone # you can be reached at during presentation *
Your answer
Child's Name #1
Your answer
Child #1 Birthdate
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DD
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YYYY
Child's Name #2
Your answer
Child #2 Birthdate
MM
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DD
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YYYY
Child's Name #3
Your answer
Child's Birthdate #3
MM
/
DD
/
YYYY
Do any of your children have special needs?
If yes, please tell us more about their needs
Your answer
Do you want a certificate of attendance ?
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