Registration* I am registering as a couple (recommended) I am registering for one attendee Parent 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 and Mrs. Yoni and Rachel Fein Payment* Sign up for Empowered Parenting - $180 Sign up for Empowered Parenting - Pay in three $60 installments Payment for One Attendee* Price: How did you hear about the Empowered Parenting Initiative program? From community leaders From flyers in the community From social media From friends Other Other Would you like to join our email list to learn about our communal programming? Yes, I would like to subscribe Total $0.00 HiddenIf MonthlyCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name