Caregiver-Child Fall 2026 Course Registration
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Caregiver's Name
*
First Name
Last Name
Caregiver's Date of Birth
*
-
Month
-
Day
Year
Date
Caregiver's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Which session(s) will you be attending?
*
Please Select
Session 1: Beginning 9/1
Session 2: Beginning 10/27
Both sessions
Child's Medical Condition/Allergies
I give permission for MTCSTL, its subsidiaries, and agents the rights to use photographs/videos of me for future promotional or fundraising materials or events:
*
Yes
No
How Did You Hear About This Course?
*
Current School Affiliation **If applicable**
Please share any questions or areas of interest that you have regarding this course.
Course Fee
Payment of the Course Fee is required for you to be registered for our program. This fee is nonrefundable.
Submit
Payment
*
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Caregiver-Child Course Session 1
$300.00
$
300.00
Quantity
1
2
3
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5
6
7
8
9
10
Caregiver-Child Course Session 2
$250.00
$
250.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Should be Empty: