PortlandParentingConnection.org

Registration

Registration will continue up to October 19th at 9PM Pacific time. Please note that no lunch will be provided to those who register after October 15th. There is a hotel restaurant as well as several others located near the hotel.

Low income families can contact Dr. Ed Hofmann-Smith to discuss assistance options. Donations (see below) will help provide tickets to those in need.

Optional fields are marked with an asterisk (*).

Attendee Type:

Days you will be attending:

Saturday Sunday

Number of children accompanying a parent:

Children must be out of diapers.

Number of children who would prefer a vegetarian lunch: *

Enter the number of children who fit into each age group:

Age 4-8
Age 9-13
Age 13-16

Main Attendee (required)

Main Attendee's last name:

Main Attendee's first name:

Vegetarian lunch? *

Yes No

Second Attendee (only for couples)

Second Attendee's last name: *

Second Attendee's first name: *

Vegetarian Lunch? *

Yes No

Contact Information

Street:
City:
State: Zip:
E-mail:
Phone: *	- -
Would you like to be included on our E-mail mailing list? *	Yes
How did you hear about Portland Parenting Connection?*
So that we may better serve your group in the future, please list any school or organization with which you are affiliated.*

Donations

Donate to our fund to provide tickets for low income families:*

Donate to the Portland Parenting Organization to help pay for future events:*