OU Empowered Parenting Initiative Registration*I am registering as a couple (recommended)I am registering for one attendeeParent Name* First Last Parent Email* Parent Phone*Parent #2 Name* First Last Parent #2 Email* Parent #2 Phone*Which course would you like to join?*Rabbi Noah and Mrs. Ruti Kunin - Beginning 12/12Rabbi Ezra and Mrs. Elyssa Goldschmiedt - Beginning 12/15Payment*Sign up for Empowered Parenting - $180Sign up for Empowered Parenting - Pay in three $60 installmentsPayment for One Attendee* Price: $100.00 How did you hear about the Empowered Parenting Initiative program? From community leaders From flyers in the community From social media From friends Other OtherWould you like to join our email list to learn about our communal programming? Yes, I would like to subscribe Total $0.00 If MonthlyCredit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name