	PROMOTING PLAY
DEFENDING CHILDHOOD
INSPIRING CAREGIVERS
CAREGIVER PLAY DAY REGISTRATION FORM

Please provide the information requested:

Please select the item that best describes you:

Family Child Care	Head Start
Center Based Child Care	Pre School
Parent	Child Care Support
Grandparent	Other

How did you learn about this event:

What next:
After submitting this form, click on the Return To The Form link on the confirmation page and use THIS LINK to connect to our online store where you can pay for this event using Visa, MasterCard, Discover Card, PayPal, or a check.

We will verify receipt of your Registration Form and Payment via email and share additional information about the event upon their receipt.

Email us at explorations@cableone.net with any questions.

OUR MISSION

Empowering children and their caregivers to play, explore, and discover.

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1524 Summit Street
Sioux City, IA 51103

Copyright 2009
Explorations Early Learning

explorations@cableone.net