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“Anything Goes” Party! Child Registration

Name: “Anything Goes” Party! Child Registration
Start: 2023-06-24T11:00:00-04:00
End: 2023-06-24T14:00:00-04:00
Location: Lighthouse Autism Center, Castleton

June 24 at 11:00 am - 2:00 pm EDT

"Anything Goes" Party: Child Registration

Please complete the form below to register the child on your caseload for the “Anything Goes” Party.

Registration

Name of Child You're Registering

Name of Child Not Listed

First

Last

Name of Person Registering Child

First

Last

Email Address of Person Registering Child

Cell Phone # of Person Registering Child

Person Registering Child Is

Child's Adoption Consultant

Child's FCM

Child's Worker (not FCM)

Child's Residential Support

Child's Current Placement

Foster Home

Residential

If Residential, please provide name of facility and city.

Transportation

Please select one.

Transporter has been identified.

Transporter has not yet been identified.

Name of Transporter

First

Last

Email Address of Transporter

Cell Phone # of Transporter

Details

Date:: June 24
Time:: 11:00 am - 2:00 pm EDT
Event Category:: Other Events

Organizer

: Indiana Adoption Program
Phone: (855) 677-KIDS
Email: iap@fireflyin.org
: View Organizer Website

Venue

: Lighthouse Autism Center, Castleton
: 7526 E. 82nd St
Castleton, IN 46256 United States + Google Map
Phone: 317-222-1242
: View Venue Website

“Anything Goes” Party! Child Registration

June 24 at 11:00 am - 2:00 pm EDT