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Registration is easy! Just use the form below to sign up for one of our programs. After you fill out the form click on the “Proceed To Payment” button. You can then select a payment method to guarantee your spot in our program. If you have any questions, please use our “Contact Us” page to get further information. Thank you!

PIES Registration Form

Upcoming Sessions:•

Participant Information

First Name:•

Last Name:•

Birth Date (between 14 and 18):•

Grade:•

Adult Contact (for participants under 18)

First Name:

Last Name:

Relationship to Participant:

Contact Information

Address:•

City:•

State:•

Zip:•

Phone:

Email:•

Other Information

Username:•

Password:•

Repeat Password:•

Answer - Most Proud of, Biggest Struggles:•

Consent•

I consent to my daughter participating in the P.I.E.S. Program for 10 weeks. I understand that my child must participate in all 10 sessions as it is important for the continuity of the program and the bonding of the group. I also give P.I.E.S. permission to take and use photographs of my child on their website and for promotional materials.