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Let's Learn Together Outside NCFL Registration Form

Thank you for filling out this registration form for the National Center for Families Learning. While you may have signed up directly with the organization hosting this program, we ask that you fill out this form so that we can report your participation in Let's Learn Together Outside to our funders. Collecting this information allows us to continue to provide high quality educational programs for free to families across the country.

1. Please read before filling out this form:

I understand I am signing up for Let's Learn Together Outside, a program with 4 sessions. To complete the program, I need to attend at least 3 of the 4 sessions. This form will ask questions about me and my child. Some questions are optional. For those, I can choose “Prefer Not to Respond.” The information I give will help others learn more about the program and who is joining it. My answers will be grouped and reported with other people’s answers unless I choose “Prefer Not to Respond.” The program and researchers will protect my privacy as much as the law allows. Names, birth dates, and other personal details will not be shared or reported. If I answer any optional questions, I can ask for my answers to be deleted at any time by sending an email to Lindsey Gearin, lgearin@familieslearning.org

*This question is required.

After reading the above, please initial here:

2. Where are you participating in Let's Learn Together Outside? *This question is required.

3. Which Alabama organization are you participating with? *This question is required.

3. Which Austin organization are you participating with? *This question is required.

3. Which Louisville organization are you participating with? *This question is required.

3. Which North Carolina organization are you participating with? *This question is required.

3. Which group are you participating in at Mobile Botanical Gardens? *This question is required.

Participating child's information

3. Child's Name *This question is required.

First Name:

Middle Name:

Last Name:

4. Child's Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

5. How would you describe your participating child? *This question is required.Check all that apply.

Indigenous American or Indigenous Alaskan
Asian
Indigenous Hawaiian or Other Pacific Islander
Black or African-American
Hispanic or Latine/Latinx/Latin

White or Caucasian
Multiracial
Prefer to self-describe: Please enter an 'other' value for this selection. * This question is required.
Prefer not to respond

6. Your (Participating Caregiver's) Name *This question is required.

First Name
Last Name

7. Are you the parent or legal guardian of the participating child? *This question is required.

Please read the following and select a response:

8. I give permission for NCFL and program facilitators to use me and my children's pictures, videos, recordings, and other media in promotional efforts, release to publishers, and/or media outlets. I may revoke this at any time by emailing kbreece@familieslearning.org. *This question is required.

Please enter an 'other' value for this selection. * This question is required.

Your Information

8. How would you describe yourself? Please check all that apply. *This question is required.Check all that apply.

Indigenous American or Indigenous Alaskan
Asian
Indigenous Hawaiian or Other Pacific Islander
Black or African American
Hispanic or Latine/Latinx/Latin

White or Caucasian
Multiracial
Prefer not to respond
Prefer to self-describe: Please enter an 'other' value for this selection. * This question is required.

9. Your gender identity: *This question is required.

Please enter an 'other' value for this selection.

10. Please enter your contact information below: *This question is required.

Email Address

Phone Number

Home ZIP Code

11. What is the highest level of school you have completed?

12. What language(s) does your family speak in your home? (Please share your primary language followed by no more than two other languages your speak in your home).

My family only speaks English in our home.
Primary Language (if other than English is spoken in the home) Please enter an 'other' value for this selection.
Language 2 Please enter an 'other' value for this selection.
Language 3 Please enter an 'other' value for this selection.
Prefer not to respond

13. How many adults age 18 and over, including yourself, live in your household?

14. How many children (youth under the age of 18) live in your household?

15. Last year, that is in 2025, what was your family income from all sources, before taxes?

16. And in 2025, would you say that your total family income from all sources, before taxes, was...