* 1. Please provide you name:

* 2. Please provide your email address (optional):

* 3. Which workshop(s) do you plan to attend? (check all that apply)

* 4. Which District do your children attend (Check all that apply)?

* 5. To which grade level(s), do you children now attend (check all that apply)?

* 6. Do you have any suggestions for other topics of interest for you or other parent you know?

* 7. The YMCA will provide childcare for interested parents. If you plan to take advantage of it, please indicate how many children you plan to attend.