Parent/Child Workshop Registration Feeling Powerful, Healthy & Playful: A 3-part parent-child workshopFacilitated by Leah Frankel, MSW, LCSW, CLC Clinical Therapist and Parent Educator at MirowitzParent's Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Number of Children Attending*Name of Child 1*Birthdate of Child 1* Date Format: MM slash DD slash YYYY School Child 1 Attends*Name of Child 2Birthdate of Child 2 Date Format: MM slash DD slash YYYY School Child 2 AttendsLet us know which event(s) you would like to attend (check all that apply)! Sunday, December 8- 10-11am, Barnes and Noble (8871 Ladue Rd. 63124)- Feeling Powerful Sunday, January 26- 4-5pm, Whole Foods (1160 Town and Country Crossing Dr. 63017)- Feeling Healthy Sunday, February 23- 10-11am, at Mirowitz (348 S. Mason Rd.)- Feeling Playful Is this the first time you have attended a Mirowitz event?* Yes No Are you interested in learning more about Mirowitz?*Yes!No, thanks.Are you interested in learning more about PJ Library?*Yes!I already receive PJ Library books!No thanks! This iframe contains the logic required to handle Ajax powered Gravity Forms.