3 B's of Sexuality

Registration

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Contact Information
Payment Plan
If you are requesting funding from your Regional Center, please check box and fill out following information:

If you are using Self Determination funds, please fill out this information:

Please fill out the following information:

Workshop(s) I will be attending:
Puberty sessions are for parents and teens. Relationship and Dating workshops are for TEENS and YOUNG ADULTS ONLY.

Please click the button below to download a required waiver to attend this conference. One waiver can be used for an entire family (there does not need to be a separate form for each individual). This document can be digitally signed or you can print it out, sign it by hand, and upload a picture and/or scanned copy. 

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Club 21 Member Registration
Non Member Registration
Payment Option
Credit Card Information
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Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Your total payment will be
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged