Group Connection RSVP

GROUP CONNECTION RSVP

To reserve your space to attend, please RSVP at least 24 hours before the day of the event. We look forward to seeing you there!
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What is your email address?
example@example.com
What area did you want to attend the event?
What City and State do you live in?
Do you participate in our CCRC Home Visiting Program?
If yes, what is the name of your Parent Educator?
How did you hear about us?

Other
How many Adults will be attending?
How many Children (0-5 years old) will be attending?
How many older children (6-17 years old) will be attending? If none, put "0".
Which Group Connection(s) will you be attending? Please note the address for each event is 250 Grand Cypress Ave, Palmdale, CA 93551:
Which Group Connection(s) will you be attending? Please note the address for each event in the San Fernando Valley:
To request additional information or should you have any questions, please contact us at (661) 789-1200 Ext. 9401
Should be Empty:

GROUP CONNECTION RSVP