Southwest Regional Parent Summit 2025 Registration
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Registration is for the Parent Summit taking place
9:00 AM to 3:00 PM
on
Saturday November 8, 2025
at
Idaho Hispanic Community Center
315 Stampede Dr, Nampa, ID 83687
Once you have registered, you will be sent an email with your registration confirmation There are several questions below that we need more information about,
On-site childcare will not be provided. Limited stipends are available to help cover childcare costs. Email info@theshiftedmindset.com for details
Information About The Parent Attending
Are you a:
Parent
Professional
More Details on 'Parent'
Please select...
Parent
Foster Parent
Grandparent
Kinship Care
Single Parent
Step Parent
Other (Fill out below this)
If You Chose 'Other'
First Name:
Last Name:
Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaskan Native
Other
Unknown
Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Phone Number:
Email Address:
Join Mailing List
If you would like to be on IPUL's mailing list check this box.
Mailing Address
Mailing City
Mailing State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
This address is my
Home
Work
Professional Information
Organization Name:
My Title:
Phone Number:
Only if different from above
Email Address:
Only if different from above
If your child does not have a disability, please type "None" in Diagnosis.
Information About Your Child
Please only enter information for an individual child, you will be able to add more children below.
Child's First Name:
Child's Last Name:
Child's Gender:
Female
Male
Child's Birthdate:
Child's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Information About Your Child (2)
Please only enter information for an individual child, you will be able to add more children below.
Child 2's First Name:
Child 2's Last Name:
Child 2's Gender:
Female
Male
Child 2's Birthdate:
Child 2's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 2's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 2's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Information About Your Child (3)
Please only enter information for an individual child, you will be able to add more children below.
Child 3's First Name:
Child 3's Last Name:
Child 3's Gender:
Female
Male
Child 3's Birthdate:
Child 3's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 3's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 3's Diagnosis:
If you have more than three children that you need assistance with, our Parent Education Coordinator will take your information directly.
Information We Need To Make Your Attending a Success
What do you hope to learn about at this summit?
How to advocate for or on behalf of my child.
How to advocate for or on behalf of my community.
Connect with parents/families like mine.
Learn about resources in my community that can help me or my family.
Something else:_____________
Something Else:
Will you need any accommodations to attend?
No
Yes
What Accommodations Do You Need to Attend?
(Interpretation, accessibility, etc)
Will you need assistance with transportation expenses?
No
Yes
Do you have any food allergies or meal restrictions?
No
Yes
What allergies or meal restrictions do you have? (We may not be able to accommodate all meal requests)
How did you find out about this event?
leave blank if the above question is "No"
Event Information
Training Name
Please select...
North Idaho Parent Summit
Southwest Idaho Parent Summit
Southeast Idaho Parent Summit
Incredibly Important Back End Stuff
(Hidden from person filling form, but
needs to be set up when building the registration or everything will be for naught and you will spend several days trying to fix your data WITH WOE IN YOUR HEART AND A POX UPON YOUR HOUSE)
Funding Source
separate with semicolon and put in
Default Value
under
Options
EXAMPLE
:
MCHB F2FHIC; PTI
(THESE NEED TO MATCH SALESFORCE OR PAIN WILL RESULT)