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Parent First Name
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Parent Last Name
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Parent Email
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Parent Phone Number
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Childs First Name
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Child Age
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Child Birthday
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Month
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Day
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Year
Session Location
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In-Office
In-Home
Payment Method
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ESA
FSA/HSA
Private Funding - Cash
Private Funding - Card
Private Funding - ACH
Course Interested In
Cooking & Meal Preparation
Cleaning & Organization
Home Maintenance & Repairs
Time Management
Gardening & Sustainability
Personal Development & Life Skills
Creative Arts & Crafts
Course Topic(s) Interested In
Basic cooking techniques
Meal planning and grocery shopping
Meal prepping
Baking
Food preservation
Cleaning routines
Laundry
Dishwashing
Home organization
DIY repairs
Basic tool knowledge
Setting routines
Goal setting
Gardening basics
Sustainable living
Urban farming
Time management & productivity
Communication skills
Mindfulness Skills
DIY projects
Art & design
Crafting with recycled materials
Sewing
Parent Address (If In-Home Appointment)
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