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Rooted - Peoria on Tuesday, September 13, 2022 @ 6:30 PM

Please complete the registration page, one per person. If you put 2 names in the first name box, only one person will be registered. 
*Childcare available for Birth - 5th Grade only*
The next 3 questions are optional, if none apply, please skip those sections.
I am interested in being an on-campus facilitator - select campus:
*To be a facilitator there is an application and training required
I would prefer to attend an off-campus Heart Crew - My zip code is CHILDCARE NOT PROVIDED:
If you do not need Childcare, please skip this section:
Please provide the total number of children along with the age or grade of your children so that we can staff accordingly.
Total number of children to attend childcare:
List age and/or grade of children:
Are there any allergies or special needs we should be aware of?: