Join Now Please fill out the form below to join Parent Talk. When complete, you’ll have the opportunity to pay membership dues via PayPal or Credit Card or Cheque. Thanks for joining! FormAction-New-Renew-UpdateUsed to indicate to Salesforce that this is a NEW application.Date Joined -- hidden and autofilled Date Format: MM slash DD slash YYYY Date Last Paid -- hidden and autofilled Date Format: MM slash DD slash YYYY Membership Expiration Date Date Format: MM slash DD slash YYYY Membership Duration*Choose 1 year membership for $100/year or 2 year membership for a total of $165 -- a $35 savings.One Year at $100Two Years at $165Parent InformationFirst Name*Last Name*Partner First NamePartner Last NameStreet Address*City/Town*State*Zipcode*Phone*Email* Please Select a Login Name*Child InformationChild 1 First Name*Birthdate* Date Format: MM slash DD slash YYYY Child 2 First NameBirthdate Date Format: MM slash DD slash YYYY Child 3 First NameBirthdate Date Format: MM slash DD slash YYYY Child 4 First NameBirthdate Date Format: MM slash DD slash YYYY Child 5 First NameBirthdate Date Format: MM slash DD slash YYYY Are any of your children twins, triplets, etc. Yes, One or more of the above children are twins, tripliets, etc. Additional InformationHow did you hear about Parent Talk?*--Please Select One--FlyerFriendsNewspaperAt an eventReal Estate AgentWebsiteOtherPlease provide additional details regarding how you heard about Parent Talk(e.g. friend's name, newspaper's name, etc.)Why did you decide to join Parent Talk*Check if interested in joining a playgroup. Yes -- I want to join a playgroup Playgroup Placement InformationPlease provide any information that will assist us in placing you in a playgroup (i.e. which child/children, new moms, dads, nannies, Saturdays, etc.)Please select zero or more days that are NOT good for a playgroup.Please Ctrl-Click on each day that is NOT good for play groups.MondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease select any special skills you may have.*Please Ctrl-Click all your Special Skills.-- Select one or more --Advertizing/Marketing/BrandingArchitecture/EngineeringComputers/Technology Services/E-CommerceConstruction/TradeEducationEntertainmentFinancial ServicesGraphics/Visual ArtsHealth CareHuman ResourcesLegalReal EstateRestaurant/RetailSports IndustryWriting/Journalism/EditingNothing at this timeWould you like your name and contact information to be included in the Parent Talk directory?If you choose to be included, your name, picture (if you upload one), how many posts you have contributed and your email will be included in the directory. ONLY PARENT TALK MEMBERS CAN SEE THE DIRECTORY.Yes, please INCLUDE me in the Parent Talk DirectoryNo, please EXCLUDE me from the Parent Talk DirectoryWould you like to be included on email communications from Parent Talk?Yes, Please INCLUDE me on Parent Talk emailsNo, Please EXCLUDE me from Parent Talk emailsParent Talk offers members a number of social support and athletic groups. Please indicate if you would like to join or find out more informaiton about the following*Please Ctrl-Click one or more selections.--Please Select One--Book ClubCareer MomsFood AllergiesParent of MultiplesSoftballTennis--Nothing at this time--Volunteering with Parent Talk is a great way to meet new people and give back to your community. Which area(s) below might you be interested in volunteering?*Please Ctrl-Click one or more selections.--Please Select One--Caring CommitteeClothing SaleCommunity OutreachEventsFundraisingLecturesMembershipNewsletterPlayspacePublicityWebsite--Nothing at this time--One way way to get involved with Parent Talk and meet many other local parents is through volunteering.Each Parent Talk Member pledges at least 2 hours of their time each year to helping the organization continue the tradition of offering great programming, events, and support for local families. We'll keep you up to date on volunteer opportunities and all you have to do is select an opportunity (or more!) that appeals to you. Yes! I pledge to give 2 hours to Parent Talk this year. Know someone else who might be interested in Parent Talk?Please provide their name and email address and we would be happy to contact them.You did it! Many thanks for your time and thoughts. Please read the following paragraph and then click “Submit” to complete the membership process.In consideration of my child(ren) visiting the Parent Talk Playspace or participating in Parent Talk events, I agree to assume all risk and hereby waive and release Parent Talk, Inc. and its officers, directors, employees and agents (collectively “Parent Talk”) from any and all claims for injury, damage or loss to the person or property of my child(ren). This express waiver and release shall remain in effect as long as and whenever my child(ren) participate(s) in any Parent Talk events. In further consideration of my child(ren)’s participation in Parent Talk events, I hereby grant Parent Talk (i) permission to take photographs of me and my child(ren) at events throughout the year, and (ii) the right to use such photographs in all forms of media (including print and electronic publishing via the Internet) for informational and promotional purposes only.CancelNameThis field is for validation purposes and should be left unchanged.