Parenting and Mediation Class Online Registration

Please enter the information requested in the form below. Required fields are marked with an asterisk ( * ).

If you would like to register and pay for more than one class attendee at the same time, enter information for the first attendee and click the "Add Another Attendee" link at the bottom of the page. You may only register for one class at a time. Once you have entered information for the last attendee click the "Proceed to Make Payment" link.

You will have the option to pay online with a credit card or to bring a cashier's check, attorney's trust fund check, or money order with you to class on the next page.

General Information

What:	Mediation Orientation and Parenting: Children in the Middle
When:	1/12/2019 9:00 AM - 12:30 PM
Where:	Micah House
Your Email:	*

Attendees Information

First Name:	*
Last Name:	*
Price:	*
Email:	*
Phone:	*
County of Case:	*
Case Court Number:
May other parent attend same class? (If No, enter their name in Comments box.):	YesNo*

Address:
Comments:

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