Child and Family Resources

Registration deadline is September 19th. Early registration will help you get into your workshop choices, but we cannot guarantee your 1st or 2nd preferences will be met. Make sure you indicate all three choices by marking the workshop session under session 1 and 2 in choice order. If not, CFR will select available workshops. If you are attending an extended workshop, you are required to attend both sessions. We will recognize a participant's total years in the early childhood field, so please indicate this in the appropriate box. No confirmation will be sent.

Participants

	Name of Participant	Session 1			Session 2			Lunch		Years of Service
	Name of Participant	1st	2nd	3rd	1st	2nd	3rd	Yes	No	Years of Service
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Contact Information

First Name *

M.I.

Last Name *

Name of Program

Address *

City *

State *

Zip Code *

Phone *

Fax

E-mail*

I represent:

Family Child Care	Center	SACC
Nursery School	Parent	Presenter
Other

Diaper Bank Support - Please check here if you have added $5.00 in support of the Diaper Bank.

Diaper Bank Support - A healthy diaper change costs $112 a month. In Morris County alone there are more than 1,000 children whose families can’t afford these diapers. Diapers are not a luxury they are a necessity! Please help us provide the two million diapers needed this year.

Payment Information *

VISA MASTERCARD AMEX

Credit Card Number
Expiration Date

Printed Name of Cardholder
OR

	Pay by Check
	Make check payable to:
		Child & Family Resources Conference 111 Howard Boulevard, Suite 201 Mt. Arlington, NJ 07856

Conference Registration $96 *Discount available for programs sending four or more people - $92.00/person. Registration received on or after September 19 is $112.00, group discount not applicable, and subject to availability as determined by CFR.

Refund Policy - Cancellations made prior to September 1st will be fully refunded minus a $50 administrative fee. Cancellations after September 1st will not be refunded. Returned checks will be charged a $25.00 fee.

Additional Information/Comments

Through this conference registration, I hereby give permission to Child & Family Resources to use any photographs taken at this event.

©2002 - 2007 Child & Family Resources
111 Howard Boulevard, Suite 201 Mt. Arlington, NJ 07856
973-398-1730 Fax 973-398-0319