Dare2Care Registration Form

Name

Phone

This address will receive a confirmation email

Child Care

Yes No

List Ages of Youth 17 and under OR add "N/A" if over 18

Continental Breakfast & Lunch are included. Do you have any food allergies?

Type of allergies

Special Accommodations

Yes No

Please explain

Identify By Letter Your First Two Preferences of Breakout Sessions (i.e. D and B) or indicate N/A if not attending

If you have a question for the panelists, please write it here. We will try to get to all questions, but cannot promise all questions will get answered due to sake of time.

Description

11/22/2025 8:00am - 4:30pm

'Strengthening Families Through Faith and Mental Wellness'

• Keynote Speakers
• Panel Discussion
• Breakout Sessions
• Praise and Worship

"Special Sessions for Teens and Preteens (ages 11-17)
" Childcare available (ages 3-10 (Limited Availability)
*Parent/Legal Guardian Consent Required for all Minor Children ages 3-17

FREE ADMISSION
Continental Breakfast & Lunch Included

"Registration Required for Each Participant (ages 18+)

Dare2Care Registration Form

Description

Please Fix the Following