Event registration
Event Date: Thursday October 1st- Thursday November 12th, 2020
Event Time: 5:30-7:30 (dinner is provided at no cost to families)
Event Address: Asbury United Methodist Church, Portland Indiana
Contact us at:  Purdue Extension Office or Jay County Drug Prevention Coalition
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First & Last Name *
Email *
Best contact phone number *
Number of people in your family attending *
Will you need free childcare for children 0-9 years of age? *
If you answered "YES" to the question above, how many children need childcare?
Does anyone in your family have dietary restrictions? *
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