Powerful Interactions for Dads Cafe Registration Question Title * 1. Contact Information Name Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 2. Check One: Custodial Dad Non-Custodial Dad Question Title * 3. Which location will you attend? Newport, ArkansasJacksonport State Park, Visitor Center Meeting Room, 111 Avenue St.Saturday, February 15, 2020, 11:30 am-1:00 pm Blytheville, ARRichard B. Harrison Multipurpose Complex, 801 Elm StreetSaturday, February 29, 2020, 12:00 pm-1:30 pm Question Title * 4. How many members of your family will be in attendance? For more information, please contact Jackie Govan at 501-371-0740. Please register at: https://www.surveymonkey.com/r/picreg Question Title Done