Becoming Brave Registration

Please complete the form below to reserve your spot in the Becoming Brave Workshop.

* Tuition fee includes up to 2 caregivers per registration.

* A light breakfast and lunch will be provided on the day of Part 1, and breakfast on the day of Part 2.

* Once your registration has been processed you will receive an email confirming your place in the workshop and payment details.

Parent/Caregiver 1

First Name

Last Name

Parent/Caregiver 2

First Name

Last Name

Email Address

Phone

(###)

###

####

Which dates would you like to reserve?

Who will be attending the workshop?

Please check all that apply

Mother

Father

Grandmother

Grandfather

Other relative

Non-related caregiver (e.g. nanny, au pair)

What are your children's ages?

What are you hoping to get out of the Becoming Brave Workshop?

Do you have any food allergies or dietary restrictions? If so, please specify.

How did you hear about Becoming Brave?

Any other questions or comments?