Babysitter’s Class Registration

"*" indicates required fields

Parent/Guardian Information

Name*

First Last

Email*

Phone*

Participant Information

Name*

First Last

Age*

Do you qualify for reduced pricing?

We offer a discounted price of $60 for income-eligible families receiving at least one of the benefits listed below.

Does your family receive any of the following benefits: Basic Food (SNAP), Free or reduced price school lunch, Apple Health, or WIC (Women, Infants & Children)?*

Yes, our household receives at least one of these benefits

No, our household does not receive these benefits

Which of the following benefits does your family receive? (Check all that apply)*

Basic Food (SNAP)

Free or reduced-price school lunch

Apple Health

WIC (Women, Infants & Children)

Babysitter's Training Class - regular price*

Price:

Babysitter's Training Class - reduced price*

The regular price of the class is $80, but you qualify for a $20 discount.

Price:

Payment

Payment for this class is non-refundable. If you cannot attend the in-person class on your scheduled date, please contact Stephanie Morgareidge at Stephanie.Morgareidge@UnitedGeneral.org as soon as possible. You may be able to reschedule to a future class or transfer your spot to another person.

Total amount due

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card*

Card Details

Cardholder Name

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