Fill out the form below to sign up for the program that brought you here. (If you cannot see the form please press the reload button in the upper left-hand corner). Program Signup Program Date Please type the dates you plan to attend, or you may type "All" if you plan to attend all weeks in a series.* Is this your first time attending a group and/or using child care at Families First or Goodwin?* Yes No Name of 1st Adult* First Last Name of 2nd Adult First Last Town* City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Email* Preferred Phone*Other PhoneQuestions or CommentsChild Care*Free child care is offered for children up to age 12 while you attend, as long as space is available. Please provide information about each child for whom you are requesting child care. We will contact you within 1 business day to confirm that we are saving a space for your child(ren). Yes, I will need child care. No, I will not need child care. Name of 1st child Birth month / year Medical conditions, allergies, notesName of 2nd child Birth month / year Medical conditions, allergies, notesName of 3rd child Birth month / year Medical conditions, allergies, notesName of 4th child Birth month / year Medical conditions, allergies, notesNameThis field is for validation purposes and should be left unchanged.