Lethbridge Twins & Triplets Club Registration Form
The Lethbridge Twins & Triplets Club (LTTC) is a parents-supporting-parents group, dedicated to improving and promoting the health and well being of multiple birth families during and beyond pregnancy.
Registration Form 2021/2022
Thank you in advance for completing the form below. Membership fees are $30.00 for one year and are to be paid by the first event of the current membership year. E-transfers can be sent to contact@lethclub.org. Checks and Cash are also acceptable, please reach out to one of our LTTC Executive members should you have any questions or concerns regarding membership. More information is available at http://lethttclub.org or you may visit us at Facebook.com/theLTTC (our public page). Upon payment, members are welcome to join our private Facebook group.
Registration Date:
*
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Month
-
Day
Year
Date
Membership Fees Payments:
*
Cash
Cheque
E-transfer
Executive Exemption
Visa/Mastercard (3.5% Charge) * invoice will be emailed
Parental Information
Please note, all your information will remain private. This allows us to to plan age appropriate activities within the community.
Your Name
*
Date of Birth
*
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Month
-
Day
Year
Date
Partner's Name
Partner's Date of Birth
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Month
-
Day
Year
Date
Anniversary
Where did you hear about the LTTC
Advertisement
Club Member
OB/GYN (please include their name in "other")
Brochure
Friend/Word of Mouth
Internet
Other
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Contact
Preferred Method of Contact
*
Text/Call
Email
Facebook Messenger
Email
*
example@example.com
Monthly Newsletter
Yes, subscribe me to this newsletter. I would like to hear about upcoming club events, children's birthdays and random facts and memes.
Phone number
Address
For occasional mailing/delivery purposes only. If you chose to opt out, we'd love to still know your general community to help us plan events accessible to the majority of our members.
Emergency Contact Name
As a precaution, we ask if you could please provide an emergency contact, and their relation to you, ie. John Smith, husband/partner
Emergency Contact's Number
Expecting or Arrived?
*
Expecting
Already Arrived
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Multiples Information
Congratulations! Whether you just found out, or have been parenting multiples for a while, it's an amazing journey and we are excited celebrate with you!
Gestation of your multiples
How many weeks + days before delivery or if you are currently pregnant
Approximate Due Date/Birth Date
*
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Month
-
Day
Year
Date
Is there any other information you would like to share regarding multiples?
Example: More than one set, Run in the Family, First time Parent etc.
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Baby A/B Information
Fraternal or Identical?
*
Please Select
Identical - Male
Identical - Female
Fraternal - Male/Female
Fraternal - Female/Female
Fraternal - Male/Male
Triplets - MMF
Triplets - FFM
Triplets - MMM
Triplets - FFF
Unknown
Other
Birthdate
*
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Month
-
Day
Year
Date
Baby A
A Gender
*
Female
Male
A Gestation & Birth weights (Pounds & Ounces)
A NICU Time (if any)
Baby B
B Gender
*
Female
Male
B Gestation & Birth weights (Pounds & Ounces)
B NICU Time (if any)
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Baby C Information
Name
Birthdate
-
Month
-
Day
Year
Date
Gender
Female
Male
Gestation & Birth weights (Pounds & Ounces)
NICU Time (if any)
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Other Family Members
While your multiples are special in their own way, we don't want to forget your other children!
Number of current or expecting children
Please include previous or expected singletons, as well as children from blended families
Name & birthday of each child
*
Please list the children oldest to youngest Example: (1. Jane Doe, May 4th, 2020.)
Are there any allergies, intolerances, or other health related information we should be aware of in your household?
*
Please include who if possible.
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Offers for Expectant Mothers
Please answer ONLY if you are currently pregnant.
Are you interested in receiving our "Meals for Moms"
Yes
No
Maybe, I'd like to discuss allergies and/or diet restrictions first.
Are you interested in our Pump Rentals?
Yes
No
Maybe
Are you interested in our Preemie Closet?
Yes
No
Maybe
Are you interested in our Breast Feeding Pillows
Yes
No
Maybe
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Volunteer Interests
LTTC is totally run and operated by Volunteer Club Members. Any contribution you can give makes a difference toward the success and longevity of our Club. Help assure your club is what you want it to be. Qualifications for Executive Positions include minimum one year as a prior member. All new and returning members are open to any Chair Positions. Members can fulfill multiple roles, and share positions. Multiple members are suggested for all chair positions.
Are you interested in volunteering?
Yes, Executive Position
Yes, Chair Position
Maybe, I'd like to discuss it
Not at this time
Other
Please choose which roles you are most interested in
Executive Positions
Pumps and Pillows & Feeding Support
New Member Support
Fundraising
Chair Positions
Events - Adult
Events - Family
Events - Children
Short Term Projects (Meals for Moms)
Bi-Annual Sales
Is there anything specific you would like to be involved in?
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Club Information
This information will help us plan for the future events to make the most out of our community.
What would you like to see out of the Club this year?
*
More Family Friendly Events
More Playdates
More Online Events/Discussions/Guest Speakers
More In Person Meetings with Guest Speakers
Casual Meetings/Adult Date Nights
More Resources such as the library, pump rentals, preemie closets
More discounts, offers, & community based resources
Clothing and Equipment Sales
What Topics or Guest Speakers would you like the club to have this year?
In the past, we have had guest speakers from Mommy Connections, Parents as Teachers, the Breast Feeding Clinic, as well as other specialists such as pelvic floor therapists, nutritionists, speech therapists, and sleep trainers share their expertise. Are there any specific topics you would like to hear about in the future or ones you have enjoyed in the past?
Which Events are you most looking forward to this year (if we are able to host).
*
Family BBQ
Swimming Day
Corn Maze
Clothing and Equipment Sale
Mothers Day Dinner
Christmas Party
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Privacy & Photo Release
Photo & Information Release - We respect your privacy; therefore we require your approval to release your information (such as names, birthdates, contact information) and photos including you or your children in the LTTC database. This information will only be accessed by current LTTC executive members. Select information may be released to chair volunteers only if requested and necessary for planning purposes of that event. Photos may also be used on our website & in promotional materials; please read and agree to the following statements that best describe your position.
Please check all appropriate statements:
*
Photos of us may also be used on our website & in promotional materials, (such as our brochure).
Photos of us may be posted on our closed social media pages or secure website for members only (semi-private)
Photos of us may be used on public Instagram/Facebook promotional materials
Please do not use any photos of myself or family members.
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