Georgia PINES / GSAP Parent-Professional Workshop  Registration Form
Remember to click the "SUBMIT" button at the bottom of this form after you have completed your entries.

If registration is completed on-line, you will need to pay at time of arrival. All parent registration fees received by
January 11, 2010 will be eligible for a $50 Walmart gift certificate drawing. Must be present to win.

CLICK HERE IF YOU WISH TO DOWNLOAD A MAIL IN REGISTRATION FORM


Location (choose one): Association (choose one):

Agency/Other: 

Name(s) attending:

PINES Child Name (if appropriate): 
                              Email Address: 
                                           Phone: 

List names and ages of those you want to register for childcare:
Name Age Disability

List names and ages of those you want to register for Sibshop(must be 7-12 Years), no disability:
Name Age

Additional needs:
Sign Interpreter:  Large Print:  Other: 

Remember to click the "SUBMIT" button after you have completed your entries in order to send your registration.