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* 1. Parents' first and last names:

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* 2. Parent's email address:

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* 3. Parent's phone number:

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* 4. Number of parents attending:

Childcare Reservation Information:
Please indicate if child(ren) will need childcare.

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* 5. Name of Child 1:

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* 6. Age of Child 1:

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* 7. Childcare for Child 1?

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* 8. Name of Child 2:

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* 9. Age of Child 2:

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* 10. Childcare for Child 2?

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* 11. Name of Child 3:

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* 12. Age of Child 3:

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* 13. Childcare for Child 3?

Other Childcare Information: 

  • We have limited space for children ages 10 and under.
  • When the children's program becomes full, and if you are interested in attending and can make arrangements for other care for your child, please email tpol@parentingnow.org to register. You will receive an email confirming your spot in the group.
  • Drop-ins will not be accepted.
  • Parents are responsible for changing children's diapers and accompanying the child to the restroom.
  • If a child becomes upset, a childcare person will come to get the parent.
If you have questions, please contact Meredith Tufts, mtufts@parentingnow.org, or 541.434.4348.
COVID-19 Statement:
Our plan to protect families and staff includes: 
Limiting sizes of groups to ensure adequate space and distancing
● Enhanced cleaning and disinfection of high-touch surfaces
● Increased airflow and purification in meeting spaces
● An emergency response plan that includes an isolation and quarantine protocol should a person develop symptoms of COVID-19 or another communicable disease

Participants in our groups are required to:
● Practice good hand hygiene, masking, and social distancing
● Monitor their health and their family’s health and avoid attending in-person activities if they have symptoms of any illness, such as fever, cough, and shortness of breath

ASSUMPTION OF THE RISK. I acknowledge and understand the following:
1. Participation in an in-person group, visit or event includes possible exposure to and illness from infectious diseases including but not limited to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist;
2. I knowingly and freely assume all such risks related to illness and infectious diseases for me and my family, such as COVID-19.

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* 14. Do you acknowledge and agree to the COVID-19 statement above?

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