* Required

Confirm Your Open House Date*

Thursday, January 14, 2021, 5:30pm

Please list the names of all adults attending the Virtual Open House:

First Name:

Last Name:

Relationship to child:

First Name:

Last Name:

Relationship to child:

Student's First Namerequired

Student's Last Namerequired

Birthdate (MM/DD/YYYY)required

Genderrequired

What school does your child currently attend?required

Which year are you interested in?required

What program are you interested in?required

Parent / Guardian First Name required

Parent / Guardian Last Namerequired

Relationship to child:required

Addressrequired

Cityrequired

Staterequired

Ziprequired

Country

Emailrequired

Phonerequired

Primary home language?required

Sibling Name

Sibling Birthday

Sibling Current School

Sibling Name

Sibling Birthday

Sibling Current School

How did you hear about us?required

Which Channel?*

Facebook Instagram Twitter YouTube

Which family can we thank for referring you?required

Who can we thank for referring you?required

Which Event?*

HRP Mamas School Fair Mocha Moms - Manhattan Fair Mocha Moms - Brooklyn Fair Other Event

Which Event?required

Please explain:required

Have any questions? Let us know!

Please send a confirmation email to the address below*: