Family Registration

Kick off Week of the Young Child with Kids Day in the Park!
Families stop by for a morning of fun with many local community organizations promoting fun activities for the family. Meet a PBS KIDS character for a meet and greet. Stop by the Registration table at the event to pick up your special KLRN bag with goodies. 
Please fill this registration form to attend.
Onsite Registration will be available.
Parking can be found around San Pedro Springs Park.

Question Title

* 1. Contact information

Question Title

* 2. Including yourself, how many people will attend the event with you?
Incluyéndote a ti, ¿cuántas personas te acompañaron al screening?

Question Title

* 3. What are the ages of ALL of  the children in your household?
¿Cuáles son las edades de TODOS los niños de su hogar?

Question Title

* 4. How did you hear about this event? (Check all that apply.)
¿Cómo se enteró del evento de hoy? (Marque todo lo que corresponda.)

Question Title

* 5. Would you be interested in any of the following?
¿Estaría interesado en alguno de los siguientes?

Question Title

* 6. Are you a part of the United Way Dual Generation Program?/ ¿Eres parte del Programa de Dual Generación de United Way?

Question Title

* 7. Want tuition assistance for a job training program, monthly support and access to resources such as quality childcare, financial empowerment, parenting classes, transportation assistance and more. Dual Generation is for families that live in the following zip codes: 78202, 78203, 78205, 78207, 78208, 78210, 78215, 78218, 78219, 78220, 78222, 78227, 78237 that meet eligibility requirements, have a child(ren) ages 0-10 and want tuition assistance for a job training program, monthly support and access to resources such as quality childcare, financial empowerment, parenting classes, transportation assistance and more.

Quiere asistencia con la matrícula para un programa de capacitación laboral, apoyo mensual y acceso a recursos como cuidado infantil de calidad, empoderamiento financiero, clases para padres, asistencia con el transporte y más. Si estás interesado en el programa Dual Generación indícalo aquí. Dual Generation es para familias que viven en los siguientes códigos postales: 78202, 78203, 78205, 78207, 78208, 78210, 78215, 78218, 78219, 78220, 78222, 78227, 78237  que cumplen con los requisitos de elegibilidad, tienen hijos de 0 a 10 años y desean asistencia con la matrícula para un programa de capacitación laboral, apoyo mensual y acceso a recursos como cuidado infantil de calidad, empoderamiento financiero, clases para padres, asistencia con el transporte y más.

Question Title

* 8. Would you like to be added to the FREE Text Messaging Service Bright By Text? ​Bright by Text sends free activities, games, and resources right to your cell phone. Messages are targeted to your child’s age (0-18 Years) and include information on child development, language and early literacy, health and safety, behavioral tips, and more!/ Bright by Text le manda actividades, juegos, y recursos gratuitamente a tu celular.
Mensajes son dirigidos a la edad de tu niño e incluye información sobre el desarrollo de los jóvenes, lenguaje y alfabetismo, salud y seguridad, consejos para el comportamiento, y más!

Question Title

* 9. If you answered yes to sign up for Bright By text  please add your cell phone number here./ Para inscribirse por favor de compartir su numero de celular.

Question Title

* 10. If you answered yes to sign up for Bright By text please add the date of birth mm/dd/yy for your youngest child. / Para Insrbirse por favor de compartir la fecha de nacimiento de su nino/a mas chico.

Date

Question Title

* 11. If you are interested in receiving Bright by Text messages what is your preferred language to receive messages? / Cual language prefiere para los mensajes de Bright By Text? 

We look forward to seeing you on April 6th!

T