Event Registration

Parent/Caregiver First Name: Parent/Caregiver Last Name: Email: Phone: Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Number of participants: Ages of children: Do you receive PJ Library and/or PJ Our Way books? jkidphilly is deeply committed to fostering an inclusive community that supports families from historically marginalized and underrepresented populations through culturally relevant programming, leadership opportunities, resources, and affinity-specific community building.Please indicate, which, if any of the following apply to your family or household: May we use photos of your family in our promotional materials/Facebook? Will anyone in your group require accommodations in order to attend this event? (Please describe)